Dentistry Services in Nampa, ID




Commonly Asked Questions

When should I take my child to the dentist?
As dentists, we receive many questions from concerned parents about the dental condition of their young children. Two popular ones are, “How old should a child be for his first dental visit?” and, “Why fill baby teeth instead of pulling them if they’re just going to fall out anyway?”

As a general rule, most dentists encourage parents to bring their child to the dental office around the ages of three or four for their first visit. (If, upon visual inspection, there is a suspicion of cavities being present, then it may be necessary for the child to visit the dentist at an earlier age.) The most important goal to accomplish in the first visit is to convince the young child that the dental office can be pleasant and fun.

One way to accomplish this is to invite the child to observe Mom or Dad during a regular cleaning and checkup. In this way, a rapport can be established built on conversation, praise, and positive reinforcement in a non-threatening environment. It is important to remember that this is much more difficult to accomplish if the child’s first visit is necessitated by an emergency toothache due to longstanding decay. Thus, every effort should be made to introduce the child to the dentist before dental problems present themselves.

A major element to a successful first visit is proper preparation at home. Fear of the dentist is not innate. It is learned. Unfortunately, most of that learning occurs outside the dental office. Never speak negatively about dental visits to be made by other family members. Avoid scaring children with talk of needles, drills, and pain. Be honest, but be creative, sensitive, and positive in your conversations concerning upcoming dental visits. Try to speak of the dentist as a friend. We observe many children properly prepared by their parents, teachers, and older brothers and sisters. They come to the clinic excited to meet the dentist, to sit in the chair, and to learn about all of the fascinating equipment.

On the average, most children have some permanent teeth as early as five or six years old. But it must be remembered that they will not lose their last deciduous (baby) tooth until as late as twelve to fourteen years of age. Deciduous teeth serve a variety of important functions. Speech, diet, and esthetics are some of the most obvious, but of crucial importance is the necessity of saving space for permanent teeth. For example, if any of the baby molars are lost prematurely due to deep decay and/or abscess, then the permanent molars will drift or tip causing crowding and other orthodontic problems later. That is why the dentist makes every effort to fill and keep baby teeth that aren’t expected to fall out naturally for quite awhile.

It is important to introduce children to dental care early with home instruction. Likewise, by introducing them to the dentist at the appropriate age, not only can they can learn to enjoy the dental clinic, but many problems can be rectified early enough to avoid possible extensive and costly treatment down the road.

by Kim B. Keller DDS, PA

What is Cosmetic Dentistry?
One of the most exciting and rapidly changing aspects of the dental field today is esthetic, or cosmetic, dentistry. Discolorations, gaps between teeth, and chipped or crooked teeth can all affect our smiles. Modern materials are offering incredible opportunities for making smiles much more appealing to individuals who are uncomfortable with how their teeth appear. Three of the most popular treatments involved in cosmetic dentistry are: 1) Bleaching; 2) Composite Bonding; and 3) Porcelain Veneers.

If an individual is unhappy with the overall color or staining of his or her teeth, then bleaching may be a viable option for the patient. When the correct bleaching technique is chosen and monitored by the dentist, it can be a very safe and rewarding dental procedure with almost immediate results. (The process of bleaching will be described more completely in a future article.)

Many smiles are affected by slightly crooked teeth or spaces between teeth. Although braces may be the first treatment of choice in some of these cases, other options may be available that are much quicker and less expensive. The two most popular options include composite bonding and porcelain veneers.

Composites, often referred to as “white fillings,” are tooth-colored, epoxy resin filling materials that have been around for quite awhile. But within the last few years their strength, beauty and longevity have dramatically improved. Although composites are mostly used for filling cavities in highly visible areas, they have become very popular for cosmetic treatment in otherwise healthy teeth.

Through a process known to many as “bonding,” composite can be added to teeth so that spaces between front teeth can be filled, short teeth can be made longer, chipped teeth can be restored, or minimal discolorations can be masked. In many cases no anesthetic or removal of tooth structure is required. Cosmetic bonding with composite can usually be accomplished easily in one appointment with a cost similar to, or slightly more, than that of a filling.

Another very popular and beautiful cosmetic procedure is known as the porcelain veneer. This restoration is a thin facing made of porcelain which is cemented onto the front of a tooth. It is usually more durable and natural in appearance than composite. Porcelain veneers are often used to fill in large gaps, to mask severely discolored teeth, to properly contour small or unnatural-looking teeth, and, in some cases, to change minor crowding or crookedness.

A porcelain veneer requires the removal of a minimal amount of tooth structure. Since veneers are made in a laboratory, at least two appointments are required for this procedure. With costs similar to crowns, porcelain veneers can produce amazing improvements with an incredibly natural look.

by Kim B. Keller DDS, PA

TMJ Syndrome
Many people today suffer from what is known as Temporomandibular Joint Syndrome. The temporomandibular joint (TMJ) is more popularly known as the jaw joint. Those individuals who suffer from TMJ Syndrome often complain of one or more of a variety of symptoms. Those may include popping and clicking in the jaw joint possibly associated with pain upon opening the mouth. Headaches originating from the face, side of the head, and even the back of the neck are common among TMJ Syndrome patients.

Since the jaw joint is situated directly in front of the ear canal it is possible that TMJ Syndrome patients may also suffer from frequent earaches, stuffiness in the ears, ringing, or simply tenderness of the outer ear when it is touched. In many cases the joint itself is very tender along with the muscles surrounding it.

The TMJ differs from other joints in the body. Rather than just hinging open and closed, it also slides side to side and forward and back. This facilitates the jaw in chewing and speaking. These unique abilities of the jaw joint are accomplished due to its special design.

Between the head of the jawbone and the skull bone there is a fibrous disk on which the lower jaw can slide around. Sometimes the two bones and the disk don’t function together properly and the disk may become damaged or displaced. This improper functioning of the joint may allow the bones to rub against each other pinching nerves and blood vessels. Grating and popping noises may also be heard as the jawbone displaces itself from the disk.

TMJ Syndrome can be caused by many things including trauma resulting from a blow to the face or a whiplash type of accident. Clenching or grinding the teeth or eating hard and chewy food may be contributing factors. Sometimes a deep overbite, or a poor bite due to many missing or very crooked teeth, may be largely responsible for TMJ Syndrome.

Treatment varies depending on the severity. Mild cases often can be treated with just some home care on the part of the patient. Many cases require orthopedic and orthodontic appliances to reposition the mandible and the teeth. In the worst, long-term cases surgery might be attempted.

Patients with TMJ Syndrome should avoid chewing gum completely. They should also avoid hard or chewy foods that stress the muscles and joints. Bad habits such as clenching or grinding the teeth should be avoided because muscles that are worked too much continually go into spasm. Some other bad habits include resting your chin in your hands, chewing pencils and fingernails, lip and cheek biting, and long telephone conversations.

When TMJ Syndrome causes headaches and tender facial muscles, they should be treated the same as any other muscle spasm. Rest, gentle massaging of the sore area, and hot-packing can relieve discomfort. Anti-inflammatory drugs such as aspirin or Ibuprofen are also appropriate. If the symptoms are not gone in a few days then the individual should consider consulting with a dentist.

by Dr. George B. Keller

Periodontal Disease
“You have periodontal disease. You may lose your teeth.” When this is told to a patient, surprise and confusion often follows. What is periodontal disease? How does it differ from tooth decay? How do you get it and how can it be prevented?

Simply defined, periodontal disease is bacterial infection of the gums and bone that support the teeth. In nearly all cases it begins with inflammation of the gums, also known as gingivitis. If your gums are red (instead of pink) or if they bleed easily upon brushing or flossing, you have gingivitis and you need to give serious attention to your oral hygiene.

It is well known that dental plaque causes tooth decay. But generally not understood that plaque is also directly responsible for gingivitis and severe periodontal disease. Plaque is any colony of bacteria. Dental plaque appears as a white substance that forms in the mouth and collects around the teeth right at gum level. It also settles into pits and crevices on top of and between teeth. When we eat sugars, bacteria converts it to acids which destroy tooth structure causing cavities.

As plaque collects, the bacteria will also infect and irritate the gum tissue. This lays the foundation for the most damaging culprit involved in periodontal disease: tartar. Through a process called calcification plaque hardens and sticks to your teeth like a barnacle to a ship. We often refer to calcified plaque as calculus or tartar.

As tartar forms below the gumline it becomes a permanent source of infection until it is removed by the dentist or dental hygienist. At this point bone, as well as gum tissue, becomes affected by this constant exposure to bacterial infection. The bone begins to permanently recede and, with time, the teeth become loose and will eventually be lost.

The process of periodontal disease is often slow and periodic. It is usually painless in the early and middle stages. For this purpose the American Dental Association recommends that individuals see their dentist at least twice a year in order to remove tartar and to screen for periodontal disease. When detected, it can be treated. But once bone has been lost, it usually cannot be replaced.

The way to prevent or stop active periodontal disease is to remove plaque before it becomes tartar. This can only be accomplished through persistent use of a toothbrush, floss, and other oral hygiene aids which physically remove plaque (i.e. toothpicks, rubber tips, etc.). Rinses, chewing gum, and other medications are not substitutes for brushing and flossing.

Patients often ask if it is really necessary to floss all of their teeth. We often reply, “Floss only those teeth that you want to keep.” Surprisingly, most patients do not brush and floss correctly leaving much plaque around and between teeth. Your dentist and dental hygienist are committed to improving your oral health care.

People who do not maintain good oral hygiene through daily brushing and flossing and frequent dental visits have an increased chance of losing their teeth due to severe decay or severe periodontal disease.

Because periodontal disease is usually painless, it can progress quietly and slowly and the patient may never suspect a problem.

by Kim B. Keller DDS, PA