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Anesthesia

The use of anesthesia is intended to make you as comfortable as possible during your dental procedure. Anesthesia is safe, and will be administered by a trained provider. You and Dr. Geare will decide on the amount of anesthesia that is right for you.

Before you receive anesthesia, be certain that you've told Dr. Geare about the medications you are currently taking and any allergies you have. Some forms of anesthesia require that you do not eat or drink prior to your dental appointment. If you have questions about your anesthesia, be sure to talk with [your dentist.] There are several types of dental anesthesia:

Local anesthesia is administered by application or injection in one area of your mouth. This method numbs your tissue for a short period of time. Dr. Geare will probably choose this method when filling cavities, and it is the most common anesthesia used in dental offices.

Conscious sedation is intended to help you relax during your dental procedure. It can be administered as an inhalant, such as nitrous oxide, or by oral or injected sedative. This method allows you to be relaxed, but still reactive to speech or touch.

Deep sedation is used when too much movement can hamper the safe completion of your procedure. Deep sedation can be administered as a sedative, or at times general anesthetic is required. During deep sedation or general anesthesia you will be unconscious or unable to respond to verbal commands.

Anxiety

For some, anxiety is a normal part of visiting the dentist. There are any number of factors that can make you anxious about your dental visit. Our staff has a long history of patient care and will explain to you by phone what to expect during your appointment. We will answer all of your questions, and hopefully reduce your level of anxiety and put you at ease before you even enter our office.

Dr. Geare wants you to be as comfortable and relaxed as possible during your procedure. We offer diversions such as [television, digital music players, movies and even virtual reality glasses].

If you are bringing your child to our office, we are happy to provide a tour and explain the instruments so that your child is more comfortable. Of course, we welcome you to accompany your young children if that will reduce their level of anxiety.

Helpful Tips
Caffeine and sugar have a tendency to make you more anxious, so try to avoid them before your dental appointment. Eating something with protein, like a high-protein bar, prior to your appointment could provide have a calming effect. During your procedure, remember to focus on your breathing. Breathe slowly. Like most anxieties, talking about your concerns can really help calm you down. So try talking with Dr. Geare about your fears and apprehensions beforehand.

Canker and Cold Sores

Canker and cold sores share a few common traits. They both occur in and around the mouth, and both cause discomfort. Unsure which type you have? Here is a description of each:

Canker sores are not contagious and generally appear inside your mouth. They are caused by bacteria and can occur after a shock, such as biting the inside of your cheek or poking your gums unintentionally. Canker sores generally last one to two weeks.

Cold sores are contagious and appear outside your mouth, generally around your lips. They are viral and caused by the herpes simplex virus. This is not the same virus that causes genital herpes, don't worry! These small, clear blisters generally last for one week.

Cavities

It's a vicious cycle. Plaque causes tooth decay and tooth decay causes cavities. The good news is that you can prevent cavities completely, or reduce the number of cavities you get in your lifetime.

Plaque Happens
When you eat high carbohydrate foods that contain starch and sugar, the deposits left on your teeth interact with plaque and produce an acid that dissolves tooth enamel and results in tooth decay and cavities. Plaque occurs naturally in your mouth from your own bacteria, but the sugars and starches are invaders that must be stopped!

Everyone can get cavities, and everyone has the tools to prevent them. Here are the best ways:

Helpful Tips to Prevent Cavities

• Don't eat too many sweets or starchy snacks. When you do, brush your teeth as soon as you can.
• Brush after every meal and floss daily. Use fluoride toothpastes that have the American Dental Association logo.
• Visit Dr. Geare every six months for a checkup and cleaning. Untreated cavities can turn into root canal infections, or result in tooth loss.

Crowns

Crowns are an ideal way of restoring teeth that are broken, have an unsightly filling or are weak and decayed. Crowns fit over the shaped remainder of the tooth and are sometimes called "caps." They are an attractive way to make your teeth stronger and more appealing.

Your Procedure
Dr. Geare will remove enough tooth tissue to allow room for the crown to fit over the tooth. Impressions are taken, top and bottom, to allow the technician to craft your crown in the laboratory. A temporary plastic crown is fitted, and when your permanent one is ready, (usually in one to two weeks) Dr. Geare cements it into place.

Taking Care of your Crowns
Your crowns should last for 5-8 years. If you grind your teeth, chew ice, bite your fingernails, or have other habits that could damage the crowns, the amount of time decreases.

To prevent damage, avoid chewing hard foods or using your teeth as tools. Other than visiting Dr. Geare and brushing, it is very important to eliminate plaque from the crown area. Using floss daily or intra-dental cleaners will help lengthen the life of your crowns.

Dentures

Replacing missing teeth is vital if you want to maintain your good health and appearance. A denture is a removable, prosthetic appliance that replaces natural teeth. A denture can improve the way you eat and speak, and provides a natural look and smile.

A full denture replaces all the natural teeth, while a partial denture fills the spaces that are left when teeth are lost. Full dentures can be either "immediate" or "conventional."

A conventional denture is placed in your mouth about a month after all the teeth are removed to allow for proper healing. An immediate denture put in place at the same time your teeth are removed. An immediate denture usually requires more adjustments, as it is worn while your mouth is still healing.

Your Procedure
The entire denture process takes [about one month or five appointments]. During this time, impressions are made to ensure proper fit, and test dentures are placed to help choose the correct color and shape. While most can begin to speak normally within a few hours after their final denture is put in place, eating and chewing can be uncomfortable for a few days to a few weeks.

Caring for your Denture
Your denture is fragile, and should be cleaned on a daily basis. Partial dentures should be removed before brushing your teeth. When you are not wearing your denture, it should be soaking in a cleanser solution or water so that it will not dry out. Your denture should be removed at night to let the tissues of the mouth breathe and ensure healthy gums.

Your denture will wear out over time. As you age, the bones under your denture shrink, and you may need adjustments to ensure a proper fit. Adjusting your denture regularly can extend its life.

Dry Mouth

A dry mouth can be caused by decreased fluid intake, certain medications, aging, and treatments such as chemotherapy and radiation. It can also be a sign of stress. Your salivary glands, for these or other reasons, cannot keep your mouth moist, which can lead to oral health problems.

Saliva prevents infection by controlling bacteria in the mouth, and without enough saliva, plaque builds up on your teeth much faster. You can develop tooth decay or other infections in the mouth.

Sjogren's Syndrome
Sjogren's syndrome is an autoimmune disease in which the immune system targets moisture-producing glands and causes dryness in the mouth and eyes. The majority of those afflicted are women in their late 40s. Difficult to diagnose, you may experience dryness in the eyes and mouth combined with fatigue and joint pain, and the symptoms are typical of the natural aging process.

Helpful Tips
To ease discomfort, you may want to avoid alcohol, caffeine and smoking. Dry or salty foods, as well as citrus juices can have an adverse effect. Remember to drink plenty of water and brush and floss regularly.

Fillings

When decay has eaten away at one of your teeth, a hole remains. Dr. Geare needs to fill this hole to prevent further decay. There are basically two types of filling, 'silver' fillings and 'white' fillings.

Composite Resin (White Fillings)
Composite resin, or white filling, is made of a strong resin that is matched to your surrounding tooth color. In the past, white fillings were used only on front teeth. Now, a stronger structure allows them to be used on back teeth as well. White fillings bond to tooth structure and usually require less removal of healthy tooth structure. Bonded fillings are considered more cosmetic than silver fillings.

It can take longer to fill your cavity with a composite than a silver filling, and can cost up to twice as much as silver fillings.

Flossing

There is no better way to clean the sides of your teeth and remove plaque than flossing. It is a necessary tool in the fight against tooth decay and periodontal disease. Since plaque builds up in places your ordinary toothbrush can't reach, it is important that you floss daily to prevent gum disease.

There is a type of dental floss out there that fits your needs. Waxed floss slides between your teeth more easily than an unwaxed floss, although unwaxed floss makes a sound when your teeth are clean. Tape floss is thicker and is favored by those with wider gaps between their teeth.

If you have limited dexterity or arthritis and cannot easily hold or use dental floss, you may want to try a commercially available floss holder or intra-dental cleaner.

If you are concerned about how to floss properly, ask Dr. Geare or hygienist to show you how.

Halitosis (Bad Breath)

Halitosis, or bad breath, can be an indication that you need to clean your teeth more often. It can also be an early warning sign of tooth or gum disease, or intestinal disorders. In most cases, it is caused by poor oral hygiene. The odor is a result of the decay of food particles. Some ways to lower your risk of developing halitosis include:

• Brush and floss your teeth at least twice a day
• Clean your tongue with your toothbrush or a tongue scraper
• If you have dentures, a retainer or mouthguard, clean them thoroughly before placing them in your mouth
• Chew sugarless gum to control any odor
• If you think that you suffer from chronic halitosis, Dr. Geare can help you determine its source.

Gum Diseases

Gum disease or periodontal disease is the number one cause of tooth loss. This disease attacks the gums as well as the bone, which are the foundations in which your teeth rest. Gum disease causes the bone to dissolve away from your teeth, loosening them and causing them to fall out. Anyone at any age is susceptible to gum disease. Gum disease is caused by plaque.

Aside from plaque build-up, genetics, nutrition and smoking habits can contribute to gum irritation and gum disease.

Warning Signs

• Some early warning signs include:
• Gums that bleed when you brush your teeth
• Red, swollen, puffy or tender gums
• Gums that have receded from the teeth
• Chronic halitosis, or bad breath
• Any change in the way your partial dentures fit
• Loose or separating teeth

Treatment
In the early stages, root planing is necessary. This is more aggressive than a normal tooth cleaning, and often requires numbing the area. During this procedure, the root surfaces are literally planed. This removes hard deposits and the bacteria they harbor, creates a smooth root surface that is easier to keep clean, and reduces infection because bacteria cannot reattach to the smooth surface as easily.

Prevention
Brush twice a day for at least 3 minutes each time and floss daily. If you're not sure whether you're brushing or flossing properly, Dr. Geare or dental hygienist can show you how. Other preventive tips:

• Use a toothpaste that contains fluoride
• Use a toothbrush with soft, polished bristles, and replace it every 3 to 4 months
• Avoid sugary and starchy snacks
• Avoid use of cigarettes or chewing tobacco, which irritate gums
• Visit Dr. Geare at least twice a year

Implants

A dental implant is an artificial tooth root that is placed into your jaw to hold a replacement tooth or bridge. Implants are a great option for people with good oral health who have lost teeth due to gum disease or injury. They are so natural-looking, you may forget you ever lost a tooth. With proper care, implants can last your lifetime.

Your Procedure
The dental implant is screwed into a special site prepared in the bone. This is done using local anesthesia and takes [a half hour to an hour per dental implant.] The implants are then covered with gum tissue so that they can integrate with the surrounding bone. This is basically your artificial root.

We then wait [six to twelve months] for your bone to grow around the implant. The final replacement tooth is then placed in your mouth and attached to the "root." Everyone heals differently, so the length of recovery time depends on your overall health.

Subperiosteal Implants
If you do not have enough bone width or height for the method described above, the Subperiosteal implant is used. This is custom made to rest on top of your jawbone and under your gums. Under anesthesia, an impression is made of your jawbone, and that is used to make a custom-fit implant for your jaw. After that is placed, your gums are closed with stitches and replacement teeth are attached.

Mouthguards

A mouthguard is a flexible appliance made out of plastic that is worn to protect teeth from trauma. Mouthguards help prevent injury to the mouth area, especially to the teeth, lips, cheeks, and tongue. They also protect against head and neck injuries by cushioning blows that could otherwise cause concussions or jaw fractures.

A mouthguard is especially important for athletes who wear braces or have fixed bridge work. A blow to the face could damage fixed orthodontic appliances. A mouthguard provides a barrier between the braces and your cheek or lips, limiting the risk of soft tissue injuries.

Types of Mouthguards

• A stock mouthguard offers the least protection and may interfere with speech and breathing because it requires that the jaw be closed to hold it in place.
• Mouth-formed protectors mold to your teeth when moistened.
• Custom-made mouth protectors offer the best protection. It is made by a dental lab from Dr. Geare's impression of your teeth.

Mouthguard Care

• After each use, clean your mouthguard in cool, soapy water and rinse it thoroughly.
• Check the condition of your mouthguard to see if it needs replacement. Tears and perforations can irritate your mouth tissues and diminish the amount of protection the mouthguard can provide.
• Don't leave your mouthguard in direct sunlight or in a hot automobile.
• Never handle or wear someone else's mouthguard.

Nutrition

You can prevent tooth decay and gum disease by changing or improving your diet. Sugary snacks may taste good, but they are not good for your teeth or your body. Starchy snacks, like crackers and cookies, break down into sugars once they are in your mouth.

When plaque on your teeth is mixed with these sugars, it turns into an acid that can dissolve your tooth enamel and cause cavities. Gooey or chewy sweets can do even more damage, as they stick to your teeth, giving the plaque more time to form the acid.

These acids affect your teeth for at least 20 minutes after you eat, which is why it is so important that you floss and brush your teeth after every meal and try not to snack. It is better for your teeth and your overall health.

Poor nutrition can affect your entire immune system, putting you at higher risk for gum disease. Drinking plenty of water is also good for your oral health, as it keeps your mouth moist, and saliva protects both hard and soft oral tissues.

Talk to Dr. Geare about what you can do to improve your oral health through dietary changes.

Oral Cancer

There are 40,000 new cases of oral cancer reported each year in the United States. The vast majority occur in people older than 45 years, with men being twice as likely as women to develop the disease. Dr. Geare can perform a thorough screening for oral cancer.

Risk Factors

• Cigarette, cigar, or pipe smoking-Smokers are six times more likely than non-smokers to develop oral cancers.
• Use of smokeless tobacco products-Use of these products increases the risk of cancers of the cheek, gums, and lining of the lips 50 times.
• Excessive consumption of alcohol-Oral cancers are about six times more common in drinkers.
• Family history of cancer
• Excessive exposure to the sun, especially at a young age

Warning Signs

• Swellings/thickenings, lumps or bumps, rough spots/crusts/or eroded areas on the lips, gums, or other areas inside the mouth
• Velvety white, red, or speckled (white and red) patches in the mouth
• Unexplained bleeding in the mouth
• Unexplained numbness, loss of feeling, or pain/tenderness in any area of the face, mouth, or neck
• Persistent sores on the face, neck, or mouth that bleed easily and do not heal within two weeks
• A soreness or feeling that something is caught in the back of the throat
• Difficulty chewing or swallowing, speaking, or moving the jaw or tongue
• Hoarseness, chronic sore throat, or changes in the voice
• Ear pain
• A change in the way your teeth or dentures fit together
• Dramatic weight loss

Treatment
Oral cancer is treated the same way many other cancers are treated; that is with surgery to remove the cancerous growth followed by radiation therapy and/or chemotherapy (drug treatments) to destroy any remaining cancer cells.

Prevention
You can take an active role in preventing oral cancer:

• Conduct a self exam at least once a month. Using a bright light and a mirror, look and feel your lips, gums, the roof of your mouth, the lining of your cheeks, and your tongue. Feel for lumps or enlarged lymph nodes in both sides of your neck and under your lower jaw. Call Dr. Geare's office immediately if you notice any changes.
• Visit Dr. Geare at least twice yearly for check-ups and cleaning
• Don't smoke or use any tobacco products and drink alcohol in moderation
• Eat a well balanced diet
• Limit your exposure to the sun

Pain

Orofacial pain is a complex area of medicine with disorders overlapping many specialties. To ensure the highest level of care, it sometimes requires working with Dr. Geare in addition to your neurologist, orthopedist, oral surgeon, or physical therapist.

Orofacial pain involves the chewing (masticatory) muscles or temporomandibular (TMD) joint. Problems can include joint discomfort, muscle spasms, migraines, frequent headaches and pain associated with the teeth, face or jaw.

Headaches
Signs that may indicate your headache is related to something dental include:

• Pain behind the eyes
• Sore jaw muscles upon waking
• Teeth grinding
• Clicking or popping jaw joints
• Head and/or scalp is painful to the touch
• Earaches or ringing
• Neck, shoulder or back pain
• Dizziness
• Sleep disorders such as snoring or sleep apnea

Treatment
You may get relief from orofacial pain with the help of an orthotic, or splint, that is worn over your teeth until the bite can be stabilized. Other ways to alleviate the pain include:

• Placing an ice pack on the painful area for 10 minutes, three or four times per day.
• Eating softer foods and cut food into smaller pieces.
• Keeping upper and lower teeth slightly apart except when chewing or swallowing.
• Sleeping on your back.
• Not resting your hand on your chin. When talking on the phone, don't rest the receiver on your shoulder.

Correcting your bite will ensure your overall oral health, and proper care will help reduce or eliminate orofacial pain.

Pregnancy and Oral Health

When you are pregnant, it's important to maintain a clean, healthy mouth. Taking care of your teeth will ensure that you avoid any problems associated with pregnancy. Brush and floss daily and see Dr. Geare as scheduled. If brushing your teeth causes morning sickness, rinse your mouth with water or with anti-plaque and fluoride mouthwashes.

Pregnancy gingivitis
Pregnancy gingivitis is particularly common in women who do not brush and floss regularly. If you are affected, it generally begins in your second trimester. If you already have gingivitis, the condition is likely to worsen during pregnancy. Pregnancy gingivitis is characterized by swollen puffy gums that bleed when brushed or flossed.

Pregnancy tumors
Pregnancy tumors are caused by hormonal changes during pregnancy, when swollen gums become irritated. They are characterized by benign, red spherical masses which are painless, but bleed easily. They commonly occur after birth, and if they don't disappear on their own, Dr. Geare may want to remove them.

Procedures to Avoid
Only essential emergency X-rays should be taken during pregnancy, make certain you request and wear a lead shield. The best time for any dental treatment is the second trimester. You obstetrician must be consulted for any procedures that require anesthesia. Elective procedures should be delayed until after the birth of your baby.

Root Canal

Root canals are very small, thin divisions inside your teeth that branch off from the top pulp chamber down to the tip of the root. Inside the canals is pulp tissue which is made up of nerve fibers, veins, arteries, and connective tissue. When this tissue becomes infected, often due to an untreated cavity, it causes pain and can damage the tooth if it is not removed.

Your Procedure
Dr. Geare will first numb the area around the tooth that is being treated. A hole is then drilled to the pulp area, and the canal is measured with electronic imaging to determine how much filling is needed. The diseased pulp is removed, and the empty canal is cleaned out and filled. After the procedure, a cap is placed over the tooth. If the tooth does not get re-infected, it is then capped with a permanent crown.

After treatment, some inflammation may cause discomfort, which can be controlled by over-the-counter analgesics recommended by Dr. Geare.

Sealants

A sealant is a plastic material that is usually applied to the chewing surfaces of the back teeth. This resin bonds into the depressions and grooves of teeth and acts as a barrier, protecting enamel from plaque and acids. Combined with proper dental care and regular dental visits, sealants are extremely effective in preventing tooth decay. The first sealant was accepted by the American Dental Association Council on Dental Therapeutics in 1972.

Sealant Application
Dr. Geare will clean the surface of the tooth and remove all traces of the cleaning agent. The sealant is applied and allowed to harden by using a special light. Application is painless, and sealants can last from five to 10 years. This preventive procedure can help reduce your future dental expenses and protect your teeth.

Seniors

Your mouth and teeth are aging too, and require the same amount of care as the rest of you. Taking care of your oral health is as important to seniors as it is to children. Here are some considerations:

• Gum disease. Three out of four adults over age 35 have some sort of gum disease. Infections, if they aren't treated, will cause your teeth to loosen and fall out, especially if you have osteoporosis.
• Dentures. As you age, your mouth changes in shape and dentures need to be adjusted or replaced. Partial or full dentures require the same careful cleaning as your natural teeth.
• Dry mouth. Diseases and medical conditions, and many prescription medications can cause dry mouth which makes it difficult to eat, swallow, and speak.
• Oral cancer. If you are over 40, you are at greater risk for oral cancer. Even if you have no teeth of your own, you should still examine your mouth for oral cancer.
• Arthritis. If you have arthritis, you may find it difficult to brush and floss. Ask Dr. Geare for ways to overcome this problem. Certain products are designed to make dental care easier for those suffering from arthritis.

As always, the best way to continue to have good oral health is to visit Dr. Geare at least twice a year.

Sensitive Teeth

Teeth become sensitive when the dentin (the tooth layer beneath your enamel) becomes exposed. When the dentin is exposed, eating or drinking food and beverages that are hot, cold or acidic can cause pain or tingling. Touching your teeth or even exposing them to cold air can also cause pain.

Sensitivity is often defined as a short sharp pain, which is usually initiated by hot or cold foods or exposure to cold air. Aching often follows. The severity and frequency of the pain varies.

How to Reduce Sensitivity

• Use a toothpaste for sensitive teeth.
• Apply sealants or fluoride at Dr. Geare's office
• Decrease your intake of acidic foods
• Avoid using hard bristled toothbrushes or brushing your teeth too hard

If a tooth is highly sensitive for more than three or four days, you should see Dr. Geare to rule out a cavity or abscess. You may also need to change your oral hygiene habits to reduce sensitivity.

Smoking

Smoking cigarettes contributes to a decline in your oral health. The chain can be broken by brushing and flossing regularly and by stopping the use of tobacco. If you start smoking at age 18 and smoke one pack a day, you will lose 4 to 5 teeth by the time you are 35. Other impacts include:

• Increased risk of oral cancer of the mouth, pharynx, larynx and esophagus. Smoking causes 75 % of all oral cancers
• Excessive yellowing of your teeth from sticky tar deposits
• Chronic halitosis (bad breath)
• Smoker's palate (red inflammation of roof of the your mouth)
• Limited blood flow to gum tissue, restricting the necessary nutrients for healthy gums and teeth
• Tooth loss in smokers occurs at a rate of 2.9 teeth every 10 years for men and 1.5 teeth every 10 years for women
• Slower healing after any dental treatment can lead to a condition known as dry socket
• Decreased sense of taste and inability to distinguish between the taste of different foods

If you are a smoker, talk to Dr. Geare about these risks, and get the support to help you quit.

Snoring/Sleep Apnea

Snoring can be a warning sign that normal breathing is not taking place during sleep. The actual snoring sound is produced from the vibration of the soft palate and sides of the throat when the air rushes against them. The sound of snoring occurs when the airway collapses and the muscles fail to maintain their normal function.

Snoring may be indicative of sleep apnea, a cessation of breathing during sleep, which can put a great strain on the cardiovascular system. Sleep apnea, left untreated, increases your risk of heart attack and stroke. Besides snoring, other common symptoms of sleep apnea include morning headaches, dry mouth and throat, excessive daytime sleepiness sudden short-of-breath awakenings, and a loss of interest in sex.

Treatment Options
Once diagnosed, snoring and sleep apnea can be treated several ways:

• Oral Appliance Approach. A dental appliance is made to wear during sleep that gently moves the lower jaw forward causing a positive change in tongue position. While many appliances are available to treat snoring and obstructive sleep apnea, only Dr. Geare can properly select and fit the type of appliance that you need.
• Continuous Positive Airway Pressure. An air compressor and mask delivers pressurized air through the nose while you sleep. This opens up the airway from the inside - as if the air were an internal splint.
• Surgery. Surgery is the most invasive method of treatment and is performed only in cases of severe obstruction when excessive tissue reduces the airway space.

If you experience any symptoms associated with snoring or sleep apnea, consult with Dr. Geare. They can work closely with the diagnosing physician to implement and manage the prescribed therapy.

TMJ

TMJ is a popular term to describe a disorder of the jaw joints or the muscles that control the joints. Muscle spasms go hand-in-hand with displaced jaw joints. Because the nerves and muscles are so complex, people suffer from a wide range of symptoms, including:

• Headaches
• Pain behind the eyes
• Dizziness
• Earaches or ringing of the ears
• Clenching or grinding of the teeth
• Neck, shoulder, or back pain
• Numbness or tingling of the fingers

Often, when your upper and lower teeth do not come together in a way that provides the proper bracing support for your jaw against your skull, you experience the symptoms of TMJ. Since your upper and lower teeth must come together firmly each time you swallow, when your bite is unstable your muscles must work extra hard. Eventually this strain makes them feel painful.

When this condition is prolonged, your body will begin to compensate and adapt by involving muscles in the neck, back, and even sometimes those of the arms, fingers, pelvis, legs, and feet.

Treatment
The first goal is to relieve the muscle spasm and pain. Then, Dr. Geare must correct the way your teeth fit together. Often a temporary device, called an orthotic, is worn over your teeth until the bite is stabilized.

Permanent correction may involve selective re-shaping of the teeth, building crowns on the teeth, orthodontics, or a permanent appliance. Though infrequent, surgery is sometimes required to correct a damaged joint. Ultimately, Dr. Geare will stabilize your bite so that the teeth, muscles, and joints all work together without strain.

Tobacco, Chewing

Chewing tobacco affects your dental health as well as the rest of your body. Chewing tobacco includes snuff, a finely ground version of processed tobacco, and chewing tobacco in the form of shredded or pressed bricks and cakes, called plugs, or rope-like strands called twists. Users "pinch" or "dip" tobacco and place a wad in their cheek or between their lower lip and gums.

About 8,000 people die every year from tobacco use. About 70 percent of those deaths are from oral cancer. Kids who use spit tobacco products are 4 to 6 times more likely to develop oral cancer.

Your dentist can help you kick your chewing tobacco habit. In addition to cleaning teeth and treating bad breath and puffy, swollen gums associated with tobacco use, Dr. Geare may prescribe a variety of nicotine replacement therapies.

Tooth Whitening

Tooth whitening is a bleaching process that reverses discolorations of enamel (the outside layer of tooth structure) to create a whiter, brighter appearance. No natural tooth structure is lost, and no anesthetic is required. Depending on your situation, Dr. Geare may choose to [whiten in the office or provide trays for you to use at home, under their professional supervision.]

Your Procedure
Your dentist will insert a custom appliance containing tooth-whitening solution. You must wear this appliance for a period of days or weeks, depending on the level of discoloration. In many cases, nighttime application alone is sufficient to achieve the results you desire.

Veneers

Veneers are a thin, semi-transparent tooth shaped "shell" that are custom made of porcelain. They are permanently bonded to your natural teeth to enhance their shape, color, length or size. They fit your teeth precisely to look completely natural. They are stain-resistant and an excellent alternative to crowns.

They will need to be replaced between four to ten years from placement depending on your care of them.

Your Procedure
To prepare the teeth, they are buffed to allow for the thickness of the veneer. A mold is then taken of your teeth and sent to the lab to create your veneers. When the veneers are ready for placement, Dr. Geare will check their fit and get a sense of the shading. The teeth are then cleansed with specific chemicals to achieve a bond. A beam of light then hardens the cement.

Wisdom Teeth

Wisdom teeth are the third and final set of molars that most people get in their late teens or early twenties. Sometimes these teeth can be a valuable asset to the mouth when healthy and properly aligned, but more often, they require removal.

Wisdom teeth present potential problems when they are misaligned-they can position themselves horizontally, be angled toward or away from the second molars, or be angled inward or outward. In addition, they can be entrapped completely within the soft tissue and/or the jawbone or only partially break through (erupt) through the gum. Teeth that remain partially or completely entrapped within the soft tissue and /or the jawbone are called "impacted."

The removal, or extraction, of wisdom teeth is generally recommended when:

• The jaw isn't large enough to allow all the wisdom teeth to fully erupt in a correct alignment.
• Wisdom teeth only partially erupt. This allows bacteria to enter around the tooth and cause an infection. Partially erupted teeth are also more prone to tooth decay and gum disease.
• Poor alignment of wisdom teeth crowds or damages adjacent teeth, the jawbone, or nerves.
• Cysts (fluid-filled sacs) form, which can destroy surrounding teeth, the jawbone, and nerves.

Your Procedure
The relative ease with which Dr. Geare can extract your wisdom teeth depends on your situation. A wisdom tooth that is fully erupted through the gum can be extracted as easily as any other tooth. However, a wisdom tooth that is underneath the gums or embedded in the jawbone requires an incision into the gums and then removal of the portion of bone that lies over the tooth.

Often, the tooth will be extracted in small sections rather than in one piece to minimize the amount of bone that needs to be removed to get the tooth out.