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com

Smiles In Paradise Dental Clinic

Aloha and welcome to our website. Our goal is to provide you with uncompromising dental care with the utmost concern for your comfort and safety. With over 25 years of experience and countless hours of continuing education, Dr. ichael !ishime has a passion for what he does, and he treats and treatment plans every patient in the same manner he or one of his family members would want to be treated. "is goal is to #eep or return every patient to optimal oral health,function, beauty and comfort. Dr. Michael L. Nishime, DDS, FAGD, FAAID, FICOI, FADI :-

Dr. !ishime received his $.A. degree from the %niversity of "awaii in &'() and his Doctor of Dental *urgery degree from the %niversity of the +acific *chool of Dentistry in &')&. "e was inducted into the ,au -appa Omega dental honor society while in dental school. "e has been in the private practice of dentistry in "awaii since &')&, and his practice is primarily focused on implant, cosmetic and advanced restorative dentistry. "e was awarded a .ellowship in the /nternational 0ongress of Oral /mplantolgists in &''5, a .ellowship in the American Academy of /mplant Dentistry in 2112, a .ellowship in the Academy of 2eneral Dentistry in 2112 a .ellowship in the 3Academy of Dentistry /nternational in 211) and Diplomate 4$oard 0ertification5 status by the American $oard of Oral /mplantology3/mplant Dentistry in &''). "e is one of only 651 dentists in the %nited *tates that has received this

www.honoluludentaloffice.com designation title, and is currently the first and only board certified dental implantologist in the state of "awaii. Dr. !ishime has received surgical and restorative training in dental implants at the %niversity of the +acific *chool of Dentistry, the American Academy of /mplant Dentistry and the Alabama /mplant *tudy 2roup7 cosmetic dentistry at the 8as 9egas /nstitute for 0osmetic Dentistry 489/5 and American Academy of 0osmetic Dentistry7 and , :, advanced esthetic dentistry and complex oral rehabilitation from the +an#ey /nstitute for Advanced Dental ;ducation, Dawson 0enter for Advanced Dental *tudy and the *eattle /nstitute for Advanced Dental ;ducation. "e is a past president of the Western District of the American Academy of /mplant Dentistry and the Oahu Dental *tudy 0lub. Dr. !ishime is a mentor for the "awaii division of the prestigious ,erry ,ana#a +rosthodontic *tudy 2roup, and he mentors other dentists in implant dentistry through his own "awaii Dental /mplant *tudy 0lub. Dr. !ishime is listed in <Americas ,op Dentists= and <$est Dentists in "awaii=. Services:1. General Dentistry:Technology Cosmetic Dentistry Restorative Care Periodontal Care Preventive Care Dental Care for nfants and Children Dentistry for !n"ious Patient #. $ndodontics:%on Surgical $ndodontics $ndodontics Retreatment Surgical $ndodontics &. 'ral and (i"illofacial Surgery:)one Grafting Corrective *aw or 'rthognathic Surgery +acial Cosmetic Surgery S,in Treatment Dental m-lant Tem-oromandi.ular *oints /isdom Teeth 0. 'rthodontics:+irst !--ointment Two Phase Treatment Retaining Straight Teeth Tongue Thrust Technology Sterili1ation

www.honoluludentaloffice.com $mergencies 2. Pediatric Dentistry:Technology Preventive Care +irst Dental 3isit Restorative Care $mergency Care 4. Periodontics:%on Surgical Periodontal Treatment Surgical Periodontal Treatment Cosmetic Surgical Procedures Dental m-lants (aintenance

1.General Dentistry:Technology:*mile *elect is a state>of>the art facility e?uipped with the most advanced dental technology available today. We wor# to constantly optimi@e the technology in our dental offices to ensure that we can ta#e care of any dental needs our patients may have. We offer Dental Digital X-rays, intra>oral cameras, diagnostic lasers, as well as AoomBC +atients often recogni@e the brand name AoomBC from the hit television show ;xtreme a#eover. ,he 0osmetic Dentists on ;xtreme a#eover choose AoomBC as the leading teeth whitening procedure available to dentists today. Cosmetic Dentistry:/n a study completed by the American Academy of 0osmetic Dentistry, researchers found that ' out of &1 patients agree that an attractive smile is an important asset. ,hey also found that (5D of Americans agree that an unattractive smile can hurt an applicantEs chance for career success. "aving a smile you love can increase your confidence and boost your self>image. /f you are unhappy with your smile, you may be surprised to #now that modern Cosmetic Dentist Anaheim Hills CA offers many solutions to common aesthetic problems. Our office provides the full spectrum of cosmetic dentistry to our patients. Whether you are see#ing Veneers Anaheim Hills CA or simple tooth whitening or to repair croo#ed or damaged teeth, we can help you to achieve a more attractive smile. Restorative Care:-

www.honoluludentaloffice.com Tooth Filling: ,ooth 0olored .illing is One of Dental Restorati e Care Ser ices and /n the past, cavities could only be treated with unsightly metal fillings that are alloys for silver and mercury. ,hese fillings, especially when close to the front of the mouth, are highly noticeable and unaesthetic. *ometimes, the filling is so large that it causes discoloration of the entire tooth. ,hese fillings 4or restorations5 often wea#en teeth due to the large amount of the original tooth that has to be removed. Also there is a ris# of ercury poisoning that is used in the filling. odern dentistry has increasingly turned to ,ooth colored or composite fillings as a strong, safe and more natural loo#ing alternative. 0omposite fillings utili@e a soft white plastic substance that is hardened with a blue light. Crown and )ridges: When a tooth is fractured, has a large old filling, or is severely damaged by decay, your dentist may recommend the placement of a crown. 0rowns strengthen and protect the remaining tooth structure and can improve the appearance of your smile. ,ypes of crowns include the full porcelain crown, the porcelain>fused>to>metal crown 4precious F non>precious5 and the all>metal crown. .itting a crown re?uires at least two visits to the dentistEs office. /nitially, the Dentist removes decay and shapes the tooth7 ma#es an impression and fits a temporary or transitional crown of plastic or metal. /n a subse?uent visit, the dentist removes the temporary crown, fits and adGusts the final crown and cements the crown into place. .ew incidents have greater impact on dental health and personal appearance than tooth loss. When one or more teeth are missing, the remaining teeth can drift out of position, which can lead to a change in the bite, the loss of additional teeth, decay and gum disease. When tooth loss occurs, your dentist may recommend the placement of a bridge. A bridge is one or more replacement teeth anchored by one or more crowns on each side. Dental m-lant: When a tooth is lost the speciali@ed bony process that houses the tooth begins to resorb due to lac# of stimulation. ,his causes a decrease in width and height of the bone in the area the tooth is lost. !eighboring teeth and opposing teeth begin to move into the space. ,his causes food lodgment, subse?uent decay, gum disease and abnormal forces being transmitted to teeth leading to fracture of cusps which may necessitate root canal treatment or extraction. 8oss of teeth can also cause the chee# and lips to collapse giving an aged loo#.,he conse?uences of tooth loss can be prevented by replacing the lost tooth in a timely manner. Although there are several options to replace a missing tooth the number one choice for replacing lost teeth are dental implants. /mplants are tiny titanium screws or posts that are surgically placed in the bone. Once integrated into bone they act li#e roots onto which small posts are attached which protrude through the gums. ,hese posts provide stable anchors to the replacement teeth. /mplants maintain the bone height by stimulation and prevents unnecessary trimming of adGoining teeth for bridge placement. *ince implants are titanium posts there is no chance for decay on implants. /mplants can service you for several years with regular professional cleaning and proper home care. Dentures:

www.honoluludentaloffice.com O er time, !eo!le"s teeth tend to nat#rall$ deteriorate. %hen a tooth has deteriorated s#&stantiall$, it o'ten needs to &e e(tracted) and *hen m#lti!le teeth are e(tracted, dent#res ma$ &e the most a!!ro!riate sol#tion. Dent#res can create a nat#ral and health$ loo+in, set o' teeth. In addition, a !ro!erl$ 'ittin, set o' dent#res can ,reatl$ enhance $o#r smile and sense o' sel'-esteem. 0omplete and +artial Dentures 0omplete dentures are used when few original teeth remain. ,he dentist begins by removing any remaining teeth so the dentures can be fitted. "e or she then ma#es a mold of the gums and sends it to a dental lab where customi@ed dentures are constructed. +artial dentures are prepared in much the same way as a complete set and are utili@ed when only a few teeth are missing. Periodontal Gum Care :.or Americans in their 61s and beyond, the threat of gum disease 4periodontal disease5 is a very real and potentially dangerous condition. 2um disease is particularly dangerous because the progression of the disease is often painless, going undetected until it creates serious problems. Although genetics may play a small role in its development, doctors agree that gum disease is most often directly related to how well people care for their teeth and gums. Preventive Care:Regular Dental Checkup : /n order to avoid lengthy procedures F maintain a healthy disease free mouth we recommend recare every H months. ,his allows us to detect early signs of disease F provide appropriate treatment, leading to a favorable prognosis. Dental Sealants : *ealants protect the occlusal surfaces, inhibiting bacterial growth and providing a smooth surface that increases the probability that the surface will stay clean. ,he ultimate goal of sealants is penetrating into the pit and fissures of the tooth and sealing them from bacteria. S!ace Maintainers : *pace maintainers are appliances made to custom fit your childEs mouth to maintain the space intended for the permanent tooth when it decides to come in. ,hey do this by <holding open= the empty space left by a lost tooth by preventing movement in the remaining teeth until the permanent tooth ta#es its natural position in the childEs mouth. ,his treatment is much more affordable and much easier on your child than to move them bac# later with orthodontic procedures. ,hin# of space maintainers as insurance against braces. Fl#oride .reatment : ,he fluoride ion comes from the element fluorine. .luoride, either applied topically to erupted teeth, or ingested orally 4called systemic fluoride5 during tooth development, helps to prevent tooth decay, strengthen tooth enamel, and reduce the harmful effects of pla?ue. .luoride also ma#es the entire tooth structure more resistant to decay and promotes reminerali@ation, which aids in repairing early decay before the

www.honoluludentaloffice.com damage is even visible. Dental Care for nfants and Children:ost pediatric dentists will agree that regular Dental 0are for /nfants should begin by one year of age, with a dental chec#>up at least twice each consecutive year for most children. *ome children may need more fre?uent evaluations and care. /n accordance with this recommendation, the following dental chec#list for infants and toddlers has been provided by the American Academy of +ediatric DentistryI $irth to H months of ageI 0lean the infantEs mouth with gau@e after feedings and at bedtime. 0onsult your childEs pediatrician regarding fluoride supplements. Jegulate feeding habits 4bottle feeding and breastfeeding5. *ix to &2 months of ageI During this time, the first tooth should appear. 0onsult the +ediatric dentist for an examination. $rush teeth after each feeding and at bedtime with a small, soft>bristled brush. As the child begins to wal#, stay alert of potential dental and3or facial inGuries. Wean the child from breast or bottle by his3her first birthday. ,welve to 2K months of ageI .ollow the schedule of dental examinations and cleanings, as recommended by your childEs pediatric dentist. 2enerally, dental examinations and cleanings are recommended every H months for children and adults.As your child learns to rinse his3her mouth, and as most deciduous 4baby5 teeth have erupted by this age, brushing with a pea>si@ed portion of fluoridated toothpaste becomes appropriate. Dentistry for !n"ious Patient:,hrough the modern miracle of sedation dentistry for Anxious Patients, dentists can treat anxious patients and often accomplish dental wor# in one or two visits that may have re?uired many more visits without it. !itrous oxide and intravenous 4/.9.5 sedation are the two conscious sedation techni?ues most commonly used to help patients relax.

#. $ndodontics:%on Surgical $ndodontics:/n order to understand why you need !on *urgical ;ndodontic ,reatment, you must first learn about the anatomy of the tooth. ,eeth are composed of three layers, the outer enamel, the inner dentin, and the innermost layer, the pulp. ,he enamel is the outer insulating layer of the tooth that has no nerve supply. ,he next layer, the dentin is innervated and is the sensitive tooth structure. ,he pulp contains blood vessels, nerves, and connective tissue and creates the surrounding hard tissues of the tooth during development. ,he pulp is housed in the canal system within the tooth, which comprises of the pulp chamber in the crown and the root canals in the roots. ,he pulp connects to the tissues surrounding the root through the tip of the roots.

www.honoluludentaloffice.com $ndodontic Retreatment:Although initial root canal treatment was successfully completed the tooth may sometimes fail to heal. ,he tooth may become painful or diseased months or even years after successful treatment due to various reasonsI !arrow or curved or calcified canals that were untreated during the initial procedure 0omplicated canal anatomy went undetected in the first procedure ,he crown or other restoration was not placed soon enough after the procedure causing recontamination of the canal system ,he restoration did not prevent saliva from contaminating the inside of the tooth !ew decay can expose the root canal filling material to bacteria, causing a new infection in the tooth. A loose, crac#ed or bro#en crown or filling can expose the tooth to new infection. S#r,ical /ndodontics0-

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%sually, a tooth that has undergone a root canal can last the rest of your life and never need further *urgical ;ndodontics treatment. $ut if symptoms persist even after successful non>surgical endodontic treatment your endodontist may advise surgery to save your tooth. *ometimes calcium deposits ma#e a canal too narrow for the instruments used in root canal treatment re?uiring a surgical procedure to treat an infection or inflammation in the bony area around the end of your tooth. *urgery will aid in diagnosis and treatment. *urgery allows your endodontist to examine the root of your tooth, find the problem, and provide treatment. 1.Oral and Ma(illo'acial S#r,er$02one Gra'tin,0-

;xtraction of a tooth causes resorption of the supporting bone. $one resorption causes a K1>H1D decrease in its width during the first three years following extraction. $one resorption occurs at the expense of the outer plate of bone reducing the width of bone. ,hen overtime the height of bone is reduced. ,his becomes critical for anterior implants where ideal esthetics, phonetics and function are desired. /n the upper Gaw following extraction the sinus floor begins to expand further decreasing the available bone to place implants in the posterior maxilla. /n the lower Gaw the mandibular nerve runs in the bone limiting the length of the implant placed. Correcti e 3a* or Ortho,nathic S#r,er$0-

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Corrective Jaw surgery is performed by an Oral *urgeon to correct misalignment of Gaws and teeth that cannot be treated with conventional Orthodontics. /t is also referred to as *urgical Orthodontics. 0orrective :aw surgery improves chewing, swallowing, speech, breathing and facial appearance. Who are candidates for 0orrective *urgeryL :aw growth is a slow and gradual process but in some individuals the upper and lower Gaws grow at different rates causing a wide range of Gaw and facial irregularities that could lead to any of these problemsI difficulty chewing, or biting food difficulty swallowing chronic Gaw or Gaw Goint 4, :5 pain and headache excessive wear of the teeth open bite 4space between the upper and lower teeth when the mouth is closed5 unbalanced facial appearance from the front, or side receding chin protruding Gaw inability to ma#e the lips meet without straining chronic mouth breathing and dry mouth sleep apnea 4breathing problems when sleeping, including snoring Facial Cosmetic S#r,er$ I> ;very year thousands of men and women are choosing facial cosmetic surgery to improve their appearance and reduce the signs of aging. ,here are various cosmetic surgeries that are available to improve your appearance. *ome of them are as belowI )le-haro-lasty 5$yelid Surgery6 +orehead7)row 8ift Genio-lasty 5Chin Surgery6 Rhino-lasty 5%ose Surgery6 Chee,.one m-lants 5(alar !ugmentation6 +acelift 5Rhytidectomy6 8i- $nhancement $ar Surgery 5'to-lasty6 +acial and %ec, 8i-osuction S+in .reatments I> Aging causes the gradual development of facial wrin#les, which at first appear as fine surface lines that over time become deeper creases and folds. Wrin#ling of the s#in may be accelerated by excessive exposure to the sun and other elements, overactive facial expression muscles, the fre?uent use of tobacco products, poor nutrition, or s#in disorders. +ersistent facial lines, especially those involved in negative emotional expressions, may

www.honoluludentaloffice.com mista#enly potray to others, the loo# of worry, anger, anxiety, disgust or sadness, despite oneEs own positive internal feelings. /nGecting or implanting substances which either temporarily wea#en the muscles or act as s#in volume fillers serve to soften or eliminate the appearance of wrin#les and produce a more youthful, reGuvenated appearance. Dental Im!lants I> When a tooth is lost the speciali@ed bony structure that houses the tooth begins to resorb due to lac# of stimulation. ,his causes a decrease in width and height of the bone in the area the tooth is lost. !eighboring teeth and opposing teeth begin to move into the space. ,his causes food lodgment, subse?uent decay, gum disease and abnormal forces being transmitted to teeth leading to fracture of cusps which may necessitate root canal treatment or extraction. 8oss of teeth can also cause the chee# and lips to collapse giving an aged loo#. .em!oromandi&#lar 3oint4.M35 I> ,he temporomandibular Goint 4, :5 is a small Goint formed where the lower part of the s#ull meets the upper portion of the lower Gaw. ,his Goint permits the opening, closing and sideward movement of the Gaw. ,he movement of the Goint is controlled by the muscles of mastication that are attached to the lower Gaw. As a result patients with temporomandibular Goint disorders experience both Goint and muscle problems. , : disorders are not uncommon and have a variety of symptoms. +atients may complain of earaches, headaches, and soreness in the Goint area upon wa#ing up, intermittent loc#ing episodes and limited ability to open their mouth. ,hey may also complain of clic#ing, popping or grating sounds in the Goint and feel pain when opening and closing their mouth. %isdom .eeth I> %isdom teeth also referred to as third molars usually erupt between the age of &( to 25. Anthropological studies show that wisdom teeth erupt in order to compensate for the excessive wear and forward drifting of teeth due to the rough diet of early humans. odern diets are soft and refined and excessive wear of teeth is not observed. As a result there is no room for wisdom teeth to erupt. ,his causes the wisdom teeth to get impacted. %hat is an im!acted tooth6 A tooth becomes impacted when there is a lac# of space in the dental arch and its growth and eruption are prevented by overlying gum, bone or another tooth. A tooth may be partially impacted, which means a portion of it has bro#en through the gum, or totally impacted when it is unable to brea# through the gum at all.

7. Orthodontics I> First A!!ointment I> At your first appointment, our Doctor will perform a complete examination, digital x> rays may be ta#en if indicated, and an overview of any necessary treatment will be given.

www.honoluludentaloffice.com A complete diagnosis and treatment plan will be provided once diagnostic records have been ta#en. ,he appointment may ta#e up to one hour in length. ,he cost of treatment and possible financial arrangements will be presented at the first appointment. *ubse?uent appointments vary in length depending upon the treatment procedures being provided for the patient. .or example, a banding appointment might re?uire two hours but a minor adGustment may ta#e &1 to &5 minutes. *ince banding are time>intensive they are scheduled in the morning or early afternoon, while adGustments are normally scheduled in the mid and late afternoon. .*o-Phase .reatment I> ,he goal of .irst +hase ,reatment is to develop the arch forms of the upper and lower Gaws so that they match one another, as well as to guide the eruption of the permanent teeth, and to maintain or create the space necessary for their eruption. !ot all children re?uire .irst +hase ,reatment, however children over the age of seven are candidates for early orthodontic treatment since growth can be a valuable tool in assisting with Gaw development. A variety of fixed or removable appliances are available to our Doctor in helping with early intervention. After first phase treatment has been completed a removable retainer is usually placed to maintain the .irst +hase correction. Once all of the permanent teeth have erupted, Second Phase .reatment can be started. ,his re?uires the placement of braces where each tooth is aligned in harmony with the lips and tongue to create a beautiful smile and achieve facial balance. Retainin, Strai,ht .eeth I> Once your braces have been removed and you have beautiful, well aligned teeth, you will need to wear Jetaining *traight ,eeth to #eep them that way. At first, you will be as#ed to wear your retainers all the time, except when eating and brushing your teeth. After one year, when your teeth have had ade?uate time to stabili@e, your will be instructed to wear your retainers at night only./f you do not wear your retainers as instructed your teeth will move. Jotations and tipping of the teeth may occur and spaces may open between the teeth. Jetention is a lifetime commitment. As previous stated, after one year retainer wear will be decreased to night only but it will be your responsibility to continue to wear your retainers indefinitely to maintain the alignment of the teeth. As a general rule, teeth naturally shift as we age. 9ery few people have naturally straight teeth. A variety of forces act throughout life to cause the teeth to change position. ,his includes natural wearing of the teeth from chewing, placement of fillings and crowns, gum disease, removal of teeth and changes in the bones and muscles of the face with age. Although the shifting is usually very slight and gradual, if the front teeth are involved you may not be happy with your appearance. +lease call our office immediately to avoid any shifting of the teeth. /f the retainer is bent or bro#en, a new retainer must be made to maintain the alignment of the teeth. ,here is a charge for this service. /f you wait, your straight teeth may shift to the point where a retainer will not straighten them. /f this occurs, retreatment involving the placement of braces will be necessary to realign the teeth.

www.honoluludentaloffice.com f we cannot reach you or you do not hear from us periodically, please contact our office. /f you have a change of address or telephone number, please let us #now. .on,#e .hr#st I> ,ongue thrusting is the habit of placing or <thrusting= the tongue against the teeth or between the upper and lower front teeth when swallowing. /t is an infantile swallowing pattern that has been retained by an individual.We swallow between &,211 to 2,111 times per day. ,he average force exerted by the tongue against the teeth when swallowing is four pounds. /t is this constant pressure exerted by the tongue that forces the teeth out of alignment in a child with a tongue thrust problem. !o one specific cause has been identified. "owever, any one of the following may be a contributing factorI &.,humbsuc#ing 2.Allergies, nasal congestion or obstructions leading to mouth breathing 6.An abnormally large tongue K.8arge tonsils, adenoids, or fre?uent sore throats which cause difficulty in swallowing 5."ereditary factors within the family, such as a steep Gaw line H.!eurological, muscular, or other physiological abnormalities (.*hort lingual frenum 4tongue tied5 ,he force of the tongue against the teeth is an important factor in contributing to malocclusions 4bad bites5. ,his is manifested by anterior or lateral open bites where the teeth do not meet properly. any well>treated orthodontic cases have suffered relapse because of the patientEs tongue thrust swallowing pattern. /f the tongue is allowed to continue pushing against the teeth, it will tip the teeth forward and alter the orthodontic treatment result. ,he most difficult problem of all is correctly diagnosing tongue thrust. /n many cases, the tongue thrust may not be detected until the child is under orthodontic care.Diagnosis is usually made when the child exhibits a dental or speech problem that needs correction. 2enerally a tongue thrust swallowing pattern is handled in one of two waysI &.An appliance is placed by the orthodontist to control the tongue thrust 2.0orrection by oral habit training. ,his method involves wor#ing with a trained speech therapist to retrain the muscles associated with swallowing by changing the swallowing pattern. With sincere commitment and cooperation of the child, correction is possible in the maGority of cases. At the present time, successful correction of tongue thrust is as followsI &.(1D of the treated cases are successful 2.25D of the treated cases are unsuccessful due to poor cooperation or lac# of commitment on the part of the parent or child 6.5D of the treated cases are unsuccessful due to factors that ma#e correction impossible .echnolo,$ I>

www.honoluludentaloffice.com Our Doctor and our staff provide the latest in orthodontic and computer technology such asI 1.Digital radiographyI Digital x>rays are provided free>of>charge at the initial examination, if necessary, to assist in assessing the needs of the patient. /n addition, digital x>rays are ta#en as part of the comprehensive records needed to accurately diagnose and plan necessary treatment. 2.Digital photography with state>of>the>art imaging is used to assist our Doctor in the diagnosing and treatment planning of cases. 3.,he latest in orthodontic brac#et designI ,he new self>ligating brac#et 4/nnovationC brac#et by 2A05 with <super sliding= technology if offered in our practice. ,his brac#et is designed with a gate that secures the wire into the brac#et ma#ing traditional <tightening= of the braces obsolete. As a result, teeth can be moved with lighter forces. ,his means greater patient comfort and longer intervals in between appointments. ,hese brac#ets are offered in both stainless steel and ceramic 4clear5 designs. K.CD ROM com!#ter s$stem with wireless networ#ing allows for easy storage and retrieval of patient records from our data base. M>rays and photographs, along with progress updates, can be emailed to the family dentist, or other dental specialist, when necessary. .9"ouse 0alls= automatic patient confirmation system calls patients the night before their appointment to confirm appointments. H.9irtual vision glasses are offered for longer appointments to allow for viewing of movies, music videos or listening to music. 0hildren can bring their own D9DEs, ipods, or music to enGoy. Sterili8ation I> Our office uses state>of>the>art sterili@ation *ervices or procedures that meet or exceed all O*"A and ,exas state law re?uirements. Our sterili@ation e?uipment is monitored wee#ly by an independent laboratory to ensure that it is functioning properly. When treating patients, gloves and protective eyewear are always worn. as#s are worn when indicated. /mer,encies I> /f a brac#et or band comes loose or you or your child is experiencing discomfort due to appliance brea#age or a loose or long wire please call our office immediately. Our Doctor or a staff member will be able to determine if something needs to be replaced immediately. Often, instructions can be handled over the phone to alleviate the problem. /f there is an <after>hours= emergency please telephone our office and listen to the prerecorded message for instructions. 0hanging or canceling an appointment is not an emergency. A message can be left on the answering machine. Nou will be contacted the next office day to assist you in ma#ing a new appointment. 2. Pediatric Dentistr$ :! .echnolo,$ :! Our state>of>the>art facility is e?uipped with the most advanced technology available. We offer digital M>Jays, intra>oral cameras, diagnostic lasers, and AoomBC O the latest

www.honoluludentaloffice.com tooth whitening techni?ue. +atients may recogni@e the brand name AoomBC as the whitening procedure preferred by cosmetic dentists on A$0Es hit television show ;xtreme a#eover. DentalRadio,ra!hs IntraOralCamera Dia,nodent Sterili8ation and !atient sa'et$ Pre enti e Care :Our state>of>the>art facility is e?uipped with the most advanced Pre enti e Care technology. We offer digital M>Jays, intra>oral cameras, diagnostic lasers, and AoomB C O the latest tooth whitening techni?ue. +atients may recogni@e the brand name AoomB C as the whitening procedure preferred by cosmetic dentists on A$0Es hit television show ;xtreme a#eover. All children need to brush their teeth at least two times a day, at night before bedtime, and in the morning after brea#fast. $y disturbing and removing the pla?ue formation twice a day, parents can minimi@e or eliminate their childrenEs potential for decay. .or younger children a parent should brush their teeth using a pea>si@ed amount of toothpaste. As the child gets older and you see they have the dexterity and patience to properly ta#e care of their teeth, you may give over the tas#. $ut do periodically monitor their care. ,oothpaste should be approved by the American Dental Association. ,oothbrushes should be the proper si@e, smaller is better than bigger, and always use a soft nylon brush in a circular manner. ,his will prevent toothbrush abrasion, excessive wear of the enamel at the gum line. Also a toothbrush should be replaced when it is worn, bristles splayed, or after more serious colds, infection, *trep throat, etc. ,he fluoride ion comes from the element fluorine. .luoride, either applied topically to erupted teeth, or ingested orally 4called systemic fluoride5 during tooth development, helps to prevent tooth decay, strengthen tooth enamel, and reduce the harmful effects of pla?ue. .luoride also ma#es the entire tooth structure more resistant to decay and promotes reminerali@ation, which aids in repairing early decay before the damage is even visible. *ealants protect the occlusal surfaces, inhibiting bacterial growth and providing a smooth surface that increases the probability that the surface will stay clean. ,he ultimate goal of sealants is penetrating into the pit and fissures of the tooth and sealing them from bacteria. First Dental Visit :! A childEs first dental visit is an important step towards dental health. A childEs first visit should be between &) and 2K months old. ,he first dental visit is to help motivate your child and familiari@e him or her to the dental instruments in a playful way. ,he Dentist 3pedodontist will examine your childEs mouth to detect decay, assess tooth development, identify abnormal facial development, teach proper oral hygiene techni?ues and give guidance regarding oral habits. Depending on your childEs co>operation few x>rays may be ta#en to help detect hidden cavities. ,he first tooth usually erupts between H>' months of age. "owever there is a wide range of tooth eruption and it is not unusual for a child to have delayed eruption of teeth. When your child is teething he or she will be restless, may drool, gums may be sensitive, may have a low grade fever and diarrhea. ,reatment can include P massaging sore gums with a finger or teething rings, placing ice or fro@en rings on gum areas. ,he best remedy is your childEs

www.honoluludentaloffice.com pediatric dose of ,ylenol or fever reducing medication for pain. OraGel type products may wor# for a short period of time, but are not recommended. Restorati e Care :! $aby teeth serve the important function of eating, speech, and esthetics 4self image5. ,hese teeth not only help form the developing Gaws, but they hold space for the permanent teeth so that a normal bite occurs. ,he last baby tooth falls out at about twelve years of age. A decayed baby tooth can become so badly decayed that it can do damage to the permanent tooth. At times severe infections of the face, head, and nec# can be caused by infected baby teeth. *o it is important to restore baby teeth as soon as decay is first detected. ,eeth with dental decay can be restored either with amalgam 4silver5 or tooth colored fillings. /f the decay is extensive it will re?uire the restoration with a crown. /mer,enc$ Care :! /nGuries to the face, mouth and teeth are common among children. We are here to help you in the time of an emer,enc$ Dental. Do not panic, stay calm and determine the extent of inGury. /f your child has a facial 3head inGury assess whether or not you childEs inGury caused loss consciousness even for a brief moment. /f this is the case, your child should see a physician immediately. Worry about the mouth and teeth later. *top any bleeding with a clean washcloth or gau@e. /f there is swelling place cold compression on the area. As you do this, chec# for bro#en teeth and3or missing teeth. /f there are missing teeth, loo# for them. 9.Periodontics :Non-S#r,ical Periodontal .reatment0-

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Anatom$ o' the tooth s#!!ortin, str#ct#res ,o better understand periodontal diseases and treatment you need to #now the anatomy of the tooth supporting structures. ,hey include the periodontal ligament which attaches the tooth roots to the interdental bone 4soc#et5 and the gum tissue which attaches to the bone and surround the tooth nec# li#e a collar. ,he word periodontal literally means <around the tooth=. +eriodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. +eriodontal disease can affect one tooth or many teeth. /t begins when the bacteria in pla?ue 4the stic#y, colorless film that constantly forms on your teeth5 releases toxins causing gum inflammation. S#r,ical Periodontal .reatment0-

When routine scaling and root planing does not help to restore periodontal health periodontal surgery may be advised. ost common surgical procedures areI +oc#et reduction procedures Jegenerative +rocedures +oc#et Jeduction +rocedures When with routine scaling and root planing deep periodontal poc#ets cannot be cleaned your periodontist may recommend poc#et reduction procedures. During this procedure, your periodontist folds bac# the gum tissue and removes the disease>causing pla?ue and tartar. /n some cases, irregular surfaces of the damaged bone are smoothened. ,his allows the gum tissue to better reattach to healthy bone. ,he gum tissue is then secured at its new position with sutures. Jeducing poc#et depth and eliminating existing bacteria are important to prevent damage caused by the progression of periodontal disease and to help you maintain a healthy smile. ;liminating bacteria alone may not be sufficient to prevent disease recurrence. Deeper poc#ets are more difficult for you and your dental care professional to clean, so itEs important to reduce them. Jeduced poc#ets and a combination of daily oral hygiene and professional maintenance care increase your chances of #eeping your natural teeth P and decrease the chance of serious health problems associated with periodontal disease.

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Cosmetic S#r,ical Proced#res0Crown "engthening ,his procedure involves the removal of gum tissue 4gingiva5, bone or both to expose more of a toothEs structure. What itEs %sed for 0rown lengthening is done when a tooth needs to be restored, but not enough tooth is present to support a crown or a filling ,his can happen when a tooth brea#s off at the gum line, or a crown or filling falls out of a tooth that has extensive decay underneath. /f your dentist wants to repair the tooth using a crown or a large filling, he or she may need to expose more of the tooth by removing some soft tissue and3or bone. /n some cases, a condition called gummy smile, in which an unusually large amount of gum tissue shows around the upper teeth can be treated using crown lengthening. Dental Im!lants0When a tooth is lost, ,he speciali@ed bony process that houses the tooth begins to resorb due to lac# of stimulation. ,his causes a decrease in width and height of the bone in the area the tooth is lost. !eighboring teeth and opposing teeth begin to move into the space. ,his causes food lodgment, subse?uent decay, gum disease and abnormal forces being transmitted to teeth leading to fracture of cusps which may necessitate root canal treatment or extraction. 8oss of teeth can also cause the chee# and lips to collapse giving an aged loo#. Maintenance0#erio$ontal %aintenance 4+ 5 is essential to the ongoing periodontal stability of patients. Optimal periodontal health re?uires regular follow up care. Nour periodontist may advise the fre?uency of your follow up care based on the severity of your gum problem. +eriodontal maintenance care helps eliminate the bacterial pla?ue on a regular basis and facilitate healing and prevent further destruction of bone.