Family Dentist in Gresham, Oregon
Cristina P. Kennedy, D.M.D. a female dentist in Gresham, Oregon offers a full array of dental services to help you maintain healthy teeth. You can read more on this page about specific services.
|Sedation Dentistry||Root Canal Therapy|
|Teeth Whitening||Fixed Bridges|
|Dry Mouth||Family Dentistry|
How does it work?
After a consultation, if you are a candidate, IV sedation is performed under the direct supervision of an anesthesiologist.
Who is a candidate for sedation?
People who have...
- High fear
- Traumatic dental experiences
- Difficulty getting numb
- A bad gag reflex
- Very sensitive teeth
- Complex dental problems
- Hate needles and shots
- Hate the noises, smells and taste associated with dental care
- Are afraid or embarrassed about their teeth
Implants are the high technology answer for people missing one or more teeth. The technology for this has been developed over the last 30 years and offers a solution for people who would otherwise have to contemplate a future with no teeth. Based on titanium "roots", the implants can be used to completely replace missing teeth, to reclaim a confident appearance and restore complete function. Teeth that are lost either through disease like decay, gum disease, or by accident, can now be completely and confidently replaced with implants.
- Allows replacement of dentures with "natural" teeth
- Behaves exactly like your own teeth (looks and feels "real")
- Gives full confidence back to people missing teeth. They do not come out and can be chewed on as vigorously as your own natural teeth.
Implants are placed in several stages. In the first stage, a titanium tooth root is placed in the bony part of the mouth. (Although this sounds horrible, it is no worse than having a tooth out). The bone heals around the implant so that it is "integrated" (becomes as one with the jaw bone). The human body recognizes titanium in the same way as it does a tooth root, so the implants are permanently accepted by the body. At a later time, a second part of the implant is placed over the titanium root, and a new "tooth" placed on top. Implants are extremely hardy and reliable and can be used in almost any
What is a Dental Implant?
A dental implant is an artificial tooth root (titanium) that is surgically anchored into your jaw to hold a replacement tooth or bridge in place. The benefit of using implants is that they don't rely on neighboring teeth for support, they are permanent and stable. Implants are a good solution to tooth loss because they look and feel like natural teeth.
How do they work?
Strategically placed, implants can now be used to support permanently cemented bridges, eliminating the need for a denture. The cost tends to be greater, but the implants and bridges more closely resemble real teeth.
Can anyone receive dental implants?
Talk with your dentist about whether you are an implant candidate. You must be in good health and have the proper bone structure and healthy gums for the implant to stay in place. People who are unable to wear dentures may also be good candidates. If you suffer from chronic problems, clenching or bruxism, or systemic diseases, such as diabetes, the success rate for implants decreases dramatically. Additionally, people who smoke or drink alcohol may not be good candidates.
How long does the process take?
The process can take several months to complete. Technology, however, is trying to decrease the healing time involved. Each patient heals differently, so times will vary. After the implants are placed surgically, the healing process can take from three to six months and the sitting of replacement teeth no more than two months.
What is the success rate of implants?
The success rate for implants depends on the tooth's purpose and location in the mouth. The success rate is about 95% for those placed in the front of the lower jaw and 85% for those placed in the sides and rear of the upper jaw.
How do I care for implants?
Your overall health may affect the success rate of dental implants. Poor oral hygiene is a big reason why some implants fail. It is important to floss and brush around the fixtures at least twice a day, without metal objects. Your dentist will give you specific instructions on how to care for your new implants. Additional cleanings up to four times per year may be necessary to ensure that you retain healthy gums.
What is the cost of implants?
Since implants involve surgery and are more involved, they cost more than traditional bridge work. However, some dental procedures and portions of the restoration may be covered by dental and medical insurance.
The following are some of the different treatments we provide:
Veneers, Tooth Colored Fillings and Crowns, Teeth Whitening
Our office offers a wide range of services from beautiful veneers to minimally invasive reshaping of unsightly chipped teeth, depending on what is appropriate for the patient. We know that while some people may want a cosmetic "Extreme Makeover", this may not be what is appropriate for everyone. Perhaps a "Mini Makeover" is a more suitable option for someone who just may need some teeth whitening and minor reshaping and bonding. After discussing the different choices of treatment, the patient and doctor will decide together what is best.
Many of you probably have old amalgam (silver) fillings that not only look unattractive, but may also be causing harm to the tooth. Often times, these large, old fillings will cause cracks in the tooth, making it susceptible to fracturing. When the tooth fractures, it often does so without any warning signs beforehand. As a result, the fractured tooth often needs root canal treatment and a crown to save it. Other times, the tooth may fracture to the point where it cannot be saved and needs to be extracted. Another common problem with these old, large silver fillings is that they may start to leak, allowing bacteria and decay to start destroying the tooth.
With the advancement of today's technology and materials, it is now possible to restore these teeth with materials that not only look more natural, but are also better for the tooth. If there are obvious cracks and decay visible on the tooth, it is best not to wait until the tooth breaks or becomes sensitive to treat it. Rather, we may recommend replacing the old filling to avoid more serious, costly treatment. These new generation tooth colored fillings and crowns that we use will help restore the tooth to its natural beauty and function.
In just two or three dental visits, a veneer can reverse years of stains caused by foods, caffeine and tobacco use. Special thin laminates, called veneers, can also be used to correct discolored, worn down, cracked and chipped teeth. Veneers can also be used to close unsightly gaps between teeth. Stronger types of veneers made of porcelain typically last longer because they are bonded to the tooth.
An impression of the tooth must be made and a veneer molded by a lab technician. Because veneers require a small amount of enamel to be removed, they are permanent and non-reversible.
The process involves removing a thin layer of the tooth to allow for the thickness of the veneer, an impression of the tooth, and final bonding of the veneer to the tooth with special cement. A special light is used to complete the process.
Tooth Colored Fillings and Crowns
There are alternative, natural-looking materials to conventional silver-colored fillings-materials made from porcelain and composite resins, which are colored to match natural tooth enamel. Unfortunately, few materials can match the strength and durability of dental amalgam and so, tooth colored fillings may need more frequent replacement.
Common amalgam alternatives include:
Composite fillings-As stated, composite fillings are just what the name implies: a mixture of resins and fine particles designed to mimic the color of natural teeth. While not as strong as dental amalgam, composite fillings provide a pleasing aesthetic alternative. Sometimes, composite resins need to be cemented, or bonded to a tooth to allow for better adhesions.
Ionomers-Like composite resins, these materials are tooth-colored. Ionomers are made from a combination of various materials, including ground glass and acrylic resins. lonomers are typically used for fillings near the gum line or tooth root, where biting pressure is not a factor. They are more fragile than dental amalgam, however, a small amount of fluoride is released by these compounds in order to facilitate strengthened enamel in the affected area.
Porcelain (ceramic)-This material is usually a combination of porcelain, glass powder and ceramic. Candidates for porcelain fillings are typically crowns, veneers and onlays and inlays. Unlike ionomers, porcelain fillings are more durable but can become fractured if exposed to prolonged biting pressures.
Often, people with stained or discolored teeth may just need a whitening procedure in order to restore their smile.
People with stained or dull teeth usually benefit from whitening, which is a safe and effective way to brighten them. Even a stubborn single tooth that is noticeably duller or less white than your other teeth can be individually brightened.
Teeth bleaching products, which contain peroxides, actually change your natural tooth color anywhere from five to seven but even up to twelve shades brighter. If your teeth aren't very dark or stained, you may need only a few bleaching sessions. Tooth bleaching safely lightens the color of your teeth, and can last up to five years.
In general, bleaching works for most people. Tooth bleaching is most effective if your teeth are darkened from age, coffee, tea or smoking. Teeth darkened with the color of yellow, brown or orange respond better to lightening. Other types of gray stains caused by fluorosis, smoking or tetracycline can be lightened, but with less than satisfactory results.
If you're interested in brightening your smile, have your teeth evaluated by us. Not everyone is a good candidate for bleaching. In some cases of serious discoloration and pitted teeth, for example, veneers may be more appropriate than bleaching. Moreover, crown, bridges, and fillings do not bleach, so it may be necessary to replace dental work to make it blend with the new color of your bleached teeth. An x-ray of your teeth may be the only accurate way of making a true assessment.
The term bruxism is defined as; "to grind the teeth, a clenching of the teeth, associated with forceful jaw movements during sleep.
What causes bruxing to occur?
This is a very difficult question to answer. Some researchers say that if the occlusion (bite) of someone is not correct they will brux. Others say that it is a central nervous system disorder. Many say it is a multifaceted problem and that stress is a substantial contributing factor.
For all practical purposes EVERYONE bruxes. Therefore, the question is NOT whether a person does in fact brux. Rather, the better question is to what degree do they brux. The pressure that can be generated across the teeth can range from 100 to 900psi (pounds per square inch) this is an incredible amount of force. The problems outlined below occur as a result of these forces being applied over many years-slowly-and it can be difficult to recognize the cause-effect sequence.
Possible signs, complications or damage that may occur are:
1. Wearing of teeth.
Wear occurs from the movement of the teeth harshly against one another. Although all teeth may show this type of wear, it is especially noticeable when a person has front teeth that appear having the same length-as if they were filed down.
2. Breaking of teeth.
As teeth wear, the edges of front teeth and the cusps or corners of back teeth will begin to show micro fractures of cracks. These cracks cannot be seen on x-rays. Teeth with these types of fractures will either eventually chip, break a corner, or may require root canal therapy. The reason for root canal therapy is that the fracture begins on the surface of the tooth and eventually deepens until the crack enters the area of the nerve.
3. Sensitive teeth.
Usually a generalized soreness and/or a cold sensitivity.
4. Receding gums and/or teeth with gum line "notches".
Most people have been told or assume that receding gums occur because of age, or using a hard bristle brush. In fact, in many cases this is not correct. These are referred to as abrasion areas. When teeth grind hard against each other year after year, they flex at the gum line and the enamel (which ends thinly at the gum line) micro fractures away. The end result is an area at the gum line that you can feel with your fingernail which can be extremely sensitive to touch and/or cold.
5. Loose teeth.
Teeth loosen because of the "rocking" back and forth that occurs. The best analogy is the example of getting a fence post out of the ground by rocking it back and forth.
6. Periodontal pockets (loss of supporting bone around the teeth) Sometimes instead of the tooth getting loose, there may be a generalized horizontal loss of supporting bone and/or localized areas of bone loss.
7. Bony ridges (tori)
Instead of losing bone support-some people actually form "extra" bone to support the teeth (this appears as bone ridges that can be seen and felt on the jaw bones as a smooth raised area about at the level of the roots.)
8. Cheek irritation
A ridge or line of fibrosed (toughened) tissue on the inside of the cheek that corresponds to where the teeth come together. Sometimes a person will actually bite themselves along this line (especially in the most posterior molar area).
9. Sore muscles (especially in the cheek and temple area)
When these muscles are overused, they may get sore just like when you over exercise.
10. Headaches (especially upon waking)
Instead of soreness the muscle aches will appear as a headache.
11. TMJ Problems (jaw joint pain, soreness, etc.)
The jaw joint may be overloaded and resulting problems occur.
Occlusal Splint (Guard)
It would be logical to think that an acrylic splint is simply a piece of plastic used to cover and prevent the teeth from coming together while sleeping at night. This is true - BUT - most importantly, when in place it provides a correct bite so that muscles will relax.
An occlusal splint is NOT a solution, rather a method of greatly decreasing the damage caused by bruxing, it is possible to alter a bite so that a guard may not be needed-the method varies from case to case.
A denture is a removable replacement for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals.
Types of dentures
Complete dentures replace all the teeth, while a partial denture fills in the spaces created by missing teeth and prevents other teeth from changing position.
Candidates for complete dentures have lost most or all of their teeth. A partial denture is suitable for those who have some natural teeth remaining. A denture improves chewing ability and speech, and provides support for facial muscles. It will greatly enhance the facial appearance and smile.
Complete dentures are called "conventional" or "immediate" according to when they are made and when they are inserted in to the mouth. Immediate dentures are inserted immediately after the removal of the remaining teeth. To make this possible, the dentist takes measurements and makes the models of the patient's jaws during a preliminary visit.
Partial dentures are often a solution when several teeth are missing. Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases, which are connected by metal framework. Removable partial dentures attach to your natural teeth with metal clasps and devices called precision attachments. Precision attachments are generally more esthetic than metal clasps and are nearly invisible. Crowns on your natural teeth may improve the fit of a removable partial denture and they are usually required with attachments. Dentures with precision attachment generally cost more than those with metal clasps.
Root Canal Therapy
Root canals are tiny passageways that branch off from beneath the top of the tooth, coursing their way vertically downward, until they reach the tip of the root. All teeth have between one and four root canals.
Many tooth problems involve infections that spread to the pulp, which is the inner chamber of the tooth containing blood vessels, nerves and other tissues. When the infection becomes worse it can begin affecting the roots. A traumatic injury to a tooth can also compromise the pulp, leading to similar problems.
A diseased inner tooth brings a host of problems; pain and sensitivity are some of the first indications of a problem; but inside, a spreading infection can cause small pockets of pus to develop, leading to an abscess.
Root canal therapy is a remarkable treatment with a very high rate of success, and involves removing the diseased tissue, halting the spread of infection and restoring the healthy portion of the tooth. In fact, root canal therapy is designed to save a problem tooth; before the procedure was developed and gained acceptance, and the only alternative for treating a diseased tooth was extraction.
When restoration procedures such as root canal therapy, crowns, or fillings are not enough to save a tooth, it may need to be pulled or extracted.
Before a tooth is extracted, the area surrounding the tooth is numbed with a topical/and or injectable anesthetic such as Novocain.
Patients with extracted teeth sometimes need to take an antibiotic, and at the very least, take precautions following the procedure to ensure that infection doesn't occur.
Smoking, vigorous brushing and rinsing, and drinking liquids through straws are discouraged during the post-operative period because they hinder healing and may cause the wound to open. Cold compresses applied to the outside cheek near the extraction area can help reduce any swelling and promote faster healing.
Crowns are synthetic caps, usually made of a material like porcelain, placed on the top of a tooth.
Crowns are typically used to restore a tooth's function and appearance following a restorative procedure such as a root canal. When decay in a tooth has become so advanced that large portions of the tooth must be removed, crowns are often used to restore the tooth.
Crowns are also used to attach bridges, cover implants, prevent a cracked tooth from becoming worse, or an existing filling in jeopardy of becoming loose or dislocated. Crowns also serve a cosmetic use, and are applied when a discolored or stained tooth needs to be restored to its natural appearance.
A tooth must usually be reduced in size to accommodate a crown. A cast is made of the existing tooth and an impression is made. The impression is sent to a special lab, which manufactures a custom-designed crown. In some cases, a temporary crown is applied until the permanent crown is ready. Permanent crowns are cemented in place.
Crowns are sometimes confused with veneers, but they are quite different. Veneers are typically applied only to relatively small areas.
Caring for Your Crowns
With proper care, a good quality crown will last years. It is very important to floss in the area of the crown to avoid excess plaque or collection of debris around the restoration.
Certain behaviors such as jaw clenching or bruxism (teeth grinding) significantly shorten the life of a crown. Moreover, eating brittle foods, ice chips, or hard candy can compromise the adhesion of the crown or even damage the crown.
An onlay covers only a portion of the tooth and one or more cusps. It limits the amount of healthy tooth structure removed and can strengthen or reinforce the tooth.
An option for replacing missing teeth (see also implants)
A Treatment For:
- Replacing a missing tooth or teeth
- Potential bite and jaw joint problems from teeth shifting to fill the empty space
- The "sunken face" look associated with missing teeth
- Improving chewing ability
- Desire for a more permanent solution than dentures
A bridge is a single appliance that is generally attached to two teeth on each side of the space where a tooth is missing. An artificial tooth attached in the middle of the bridge fills in the gap where the tooth was. The teeth on either side of the gap are prepared for crowns (see crowns) and a highly accurate impression or mold is made of the prepared area. This mold is used to create a gold or porcelain (tooth colored) bridge in our laboratory. The bridge is then cemented onto the prepared surface of the teeth, effectively creating the appearance of a "new" tooth.
Unlike dentures, a fixed bridge is never removed. It is stable in the mouth and works very similar to natural teeth. By filling the gap and stopping the movement of other teeth, a fixed bridge is an excellent investment, providing better chewing ability, preventing jaw joint problems and saving money that might otherwise be spent on future dental treatment.
Children's dentistry is the area of dentistry that focuses on the oral health and unique needs of young people. We are concerned about your child's total health care. Good oral health is an important part of total health. Establishing us as your child's, "Dental Home" provides us the opportunity to implement preventive dental health habits that keep a child free from dental/oral disease. We focus on prevention, early detection and treatment of dental diseases, and keep current on the latest advances in dentistry for children.
Pleasant visits to the dental office promote the establishment of trust and confidence in your child that will last a lifetime. Our goal, along with our staff, is to help all children feel good about visiting the dentist and teach them how to care for their teeth.
Preventing Tooth Decay
Four things are necessary for cavities to form:
1) a tooth
3) sugars or other carbohydrates
4) and time
We can share with you how to make teeth strong, keep bacteria from organizing into harmful colonies, develop healthy eating habits, and understand the role that time plays. Remember, dental decay is an infection of the tooth. Visiting us early can help avoid unnecessary cavities and dental treatment:
Importance of Primary Teeth
It is very important that primary teeth are kept in place until they are lost naturally. These teeth serve a number of critical functions. Primary teeth:
- Maintain good nutrition by permitting your child to chew properly.
- Are involved in speech development.
- Help the permanent teeth by saving space for them. A healthy smile can help children feel good about the way they look to others.
Infants and Children
Getting an early start in regular dental care is an important step on the road to teaching your child healthy lifetime habits. We want to share with you the latest available methods for keeping your child healthy and safe.
The first dental visit should occur by the child's first birthday. Beginning tooth and mouth examinations early may lead to detection of early stages of tooth decay that can be, easily treated. At the first visit we will present:
- A program of preventive home care including brushing, flossing, diet and the importance of fluorides.
- A caries risk assessment.
- Information about Early Childhood Caries, which may be due to inappropriate nursing habits or inappropriate use of sippy cups.
- The latest facts about finger, thumb and pacifier habits.
- What you need to know about preventing injuries to the mouth and teeth.
- Information on growth and development.
Adolescents have special needs. Appearance and self-image are very important to them. Decayed or poorly positioned teeth or jaws might make them more self-conscious. Teens also eat frequently, and unhealthy snack foods tend to become a major part of their regular diet. We provide a professional, sensitive and caring approach to restoring and guiding teeth, and teaching preventive dental health care through the teen's high school years. When necessary, we will provide information on sealants, oral piercing, wisdom teeth, missing teeth and tobacco use.
Regular dental visits are crucial to maintaining a healthy smile. Take your child to see the dentist by his or her first birthday. Although this may seem early, the dentist can explain how the child's teeth should be cleaned at home, how diet and eating habits affect teeth, and examine for tooth decay.
Sealing Out Decay
A sealant is a clear plastic material that is applied to the chewing surfaces of the permanent back teeth (premolars and molars), where decay occurs most often. Pits and fissures are depressions and grooves in the chewing surfaces of the back teeth. They are difficult to keep clean because toothbrush bristles cannot reach into them. The sealant forms a thin covering that keeps out plaque and food and decreases the risk of tooth decay. As long as the sealant remains intact, the tooth surface will be protected from decay. Sealants usually last several years before a reapplication is needed.