From routine cleanings and fillings to bruxism devices, Old Greenwich Dental Associates is equipped to handle all your dental needs. To help you understand your options, we've included descriptions of some of our leading services on this page.
No matter what you might be looking for in dental care, we can provide you with high-quality care for all your dental needs, whether that includes a cleaning and exam or a full-mouth restoration. On this page, you'll find a good overview of the different services and procedures we offer our patients. We'll provide you with beautiful results, making sure that you're relaxed and that you enjoy yourself during the treatment process.
After looking over our services, feel free to contact our office with any questions you might have or to set up an appointment. We look forward to helping you achieve a beautiful, healthy smile.
Cleaning and Protection - Dental Exam
During your initial visit, Dr. Busch will give you a comprehensive exam. Dr. Busch and his hygienist will make sure to:
- Examine diagnostic x-rays (radiographs): Necessary for finding decay, tumors, cysts, and bone loss. These x-rays are also used to diagnose developmental problems of teeth growing in.
- Screen for oral cancer: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
- Check for gum disease: Examination of the gums and bone around the teeth to find any signs of periodontal disease.
- Check for tooth decay: Use of special dental instruments to test all tooth surfaces for decay.
- Examine existing restorations: Check current fillings, crowns, and other restorations
Cleaning and Protection - Professional Dental Cleaning
One of our Registered Dental Hygienists or Dr. Busch will perform a professional dental cleaning (dental prophylaxis) following you first visit or inconjunction with your exam. The cleaning will involve:
- Removal of calculus (tartar): Calculus comes from plaque build up that has hardened around the tooth. It forms both above and below the gum line, making the use of special dental instruments necessary to remove it from around the teeth.
- Removal of plaque: A sticky, almost invisible film, plaque is actually made up of living bacteria, food debris and saliva. When it forms on the teeth, the bacteria produces poisons that infect the gums, causing them to inflame. This inflammation is one of the first signs of periodontal disease.
- Teeth polishing: Through teeth polishing, your hygienist can remove stains and plaque that did not come off during the rest of the cleaning.
Cleaning and Protection - Dental X-Rays
Used as a preventive, diagnostic tool, dental x-rays, or radiographs, provide Dr. Busch with a look at what's going on under the gum line. The information that these x-rays provide is used to detect any abnormalities that aren't visible during the actual exam or cleaning. Without these x- rays, Dr. Busch will not have a complete picture of your mouth, and many problems could go undetected for a long period of time.
Dental x-rays often reveal:
- Abscesses or cysts
- Bone loss
- Cancerous and non-cancerous tumors
- Decay between the teeth
- Developmental abnormalities
- Poor tooth and root positions
- Problems inside a tooth or below the gum line
X-rays help Dr. Busch detect these dental problems at their earliest stages, which saves you time, money and pain in the long run!
Are dental x-rays safe?
Our everyday environment exposes us to natural radiation all the time. Dental x-rays from a full- mouth series emits the same level of radiation that a person receives on a daily basis from natural sources.
The low-level of radiation emitted by dental x-rays is considered safe, but we still take precautions to minimize how much exposure our patients receive. Using lead apron shields to cover the patients' bodies enable us to keep our patients' radiation exposure at the lowest level possible. In addition, our state-of-the-art digital x-rays reduce exposure by up to 90 percent when compared to traditional film methods.
How often should dental x-rays be taken?
Based on your medical and dental history, as well as your age, risk for disease and current signs/symptoms, Dr. Busch and hygienist will be able to recommend the best time frame for dental x-rays. In the end, the frequency of these x-rays will depend largely on your individual needs.
We recommend a full-mouth series of x-rays for all our new patients, so we have a better idea of their current dental health. The full-mouth series is taken every three to five years and rotates with panoramic x-rays to determine jaw health. Bite-wing x-rays, on the other hand should be taken once or twice a year during routine dental check-ups.
Cleaning and Protection - Home Care
The main goal of our team is to provide our patients with healthy, good-looking smiles that will last them a lifetime. Taking good care of your teeth at home goes a long way in achieving such a smile. Incorporating healthy meals into your diet, reducing the number of snacks you eat and brushing and flossing your teeth daily will all help reduce your chances of dental disease.
Tooth brushing - You should brush your teeth at least twice a day, especially right before you go to bed. In addition, an ADA-approved toothpaste and soft bristle tooth brush will make a difference in the effectiveness of your routine.
- When brushing your teeth, hold the tooth brush at a 45 degree angle to the gums. Use small, circular motions to brush your teeth and make sure you can feel the brush's bristles on your gums.
- Make sure to brush the whole surface of each tooth - the outer and inner sides and the biting surface.
- To clean the inside of the front teeth, use the tip of your tooth brush.
- Remove extra bacteria from your mouth by also brushing your tongue. This will also help freshen your breath.
- Electric tooth brushes are recommended, as they are the most effective in removing plaque while still being gentle on your gums and teeth. To use an electric tooth brush, put the bristles on your teeth and let the brush do the rest.
Flossing - Daily flossing allows you to clean between the teeth and under the gum line, while at the same time preventing plaque build up and protecting your gums and teeth from the damage that plaque can cause.
- When you floss, use 12-16 inches (30-40 cm). Wrap the floss around your middle fingers and leave a couple inches between your hands.
- Guide the floss between your teeth with your thumbs and forefingers, using a back-and-forth motion.
- Curve the floss around each tooth and make sure to get under the gum line, gently moving the floss up and down along the side of the tooth.
- If you struggle with conventional floss, try using a floss holder.
Rinsing - Rinsing your mouth with water after brushing (and after meals if you don't have a chance to brush) is another important step in home dental care. If you like to use an over-the- counter product for rinsing, you can talk with Dr. Busch or hygienist to find out the best one for you.
Depending on your dental health, Dr. Busch might recommend that you also use other dental aids, such as tongue cleaners, rubber tip stimulators, irrigation devices, interdental brushes, medicated rinses and fluoride.
Therasol - An irrigation that has a low alcohol content, is professional strength, and an antimicrobial irrigation agent that does not stain the teeth or increase calculus formation. This great tasting solution also maintains its presence in vitro for up to 6 hours.
Despite its strong antimicrobial properties, TheraSol is extremely mild with none of the harsh, burning sensations associated with some brands of commercial mouthwashes. It also tastes great and leaves the mouth feeling sparkling clean and refreshed. These properties make it ideal for home care use in periodontally challenged patients during their daily home-care programs.
Periodontal Disease - What is it?
Meaning "around the tooth," periodontal disease affects the gums that surround the teeth and the bones that support them. Plaque that is left to build up on teeth eventually changes from a sticky film into tartar (calculus). Together, plaque and tartar start to break down the gums and bone in the mouth. One common symptom of this disease is red, swollen and bleeding gums.
It is estimated that four out of every five people have some stage of periodontal disease but are unaware of it. Typically, this is because the first stages of the disease are often painless.
Periodontal disease is the number one cause of tooth loss, and it has also been associated with other serious diseases, such as bacterial pneumonia, diabetes, stroke, increased risk during pregnancy and cardiovascular disease. Researchers are currently trying to find out if the bacteria associated with periodontal disease affects the conditions of other systemic diseases, such as those listed. The risk of periodontal disease increases with people who smoke.
You can reduce your risk of periodontal disease through good oral hygiene, a balanced diet and routine trips to Dr. Busch.
Signs and symptoms of periodontal disease:
- Bleeding gums
- Loose teeth
- New spacing between teeth
- Persistent bad breath
- Pus around the teeth and gums
- Receding gums
- Red and puffy gums
- Tenderness or Discomfort
Periodontal Disease - Diagnosis
Dr. Busch or hygienist can diagnose this disease during a periodontal examination, which is included in your regular dental check up.
A small dental instrument called a periodontal probe is used to measure the space (sulcus) between the teeth and the gums. A healthy sulcus should measure three millimeters or less and it should not bleed. The probe will indicate if the spaces are deeper than three millimeters. Deeper pockets typically indicate a more advanced stage of the disease.
In addition to measuring the sulcus, Dr. Busch will check for inflammation, tooth mobility and other signs that will help in making a diagnosis according to one of the below categories:
The first stage of periodontal disease, gingivitis is characterized by tender, inflamed gums that are also likely to bleed during flossing or brushing.
Plaque build up will eventually harden into calculus, commonly called tartar. This build up will cause the gums to recede away from the teeth, creating deep pockets where bacteria and pus can grow. At this stage, the gums are very irritated and bleed very easily. Beginning stages of bone loss may also be seen with periodontitis.
As the gums, bone and other supporting ligaments are destroyed by periodontal disease, the teeth lose their strong anchoring. As a result, the affected teeth will start to become loose and may even fall out. Bone loss at this stage can be anywhere from moderate to severe.
Periodontal Disease - Treatment
Treatment for periodontal disease is determined by the type and severity of the disease. Your dentist and hygienist will be able to make the best treatment recommendations for your situation.
One or two regular cleanings are typically all that is necessary to clear up the early stages of gingivitis, when there has still been no bone damage. We will also provide you with tips on how to maintain healthy dental habits at home, so the disease does not return.
More advanced stages of the disease require scaling and root planning (deep cleaning). Normally, this type of cleaning is done on one quadrant of the mouth at a time, and the area being treated is made numb. This procedure removes tartar, plaque and other toxins from above and below the gum line and on root surfaces. Cleaning out these toxins helps the gums to heal, shrinking the pockets back to a normal size. Depending on the patient, we may also recommend medication, mouth rinses and an electric tooth brush to help clear up the infection.
If scaling and root planning does not clear up the problem, periodontal surgery may be necessary to get the pockets back to a normal size. Reducing the pocket size makes keeping your teeth clean much easier, and Dr. Busch may recommend that you see a specialist in this field.
Periodontal Disease - Maintenance
If plaque is not removed within 24 hours after it forms on your teeth, it turns into tartar. Regular home dental care helps prevent the formation of plaque and tartar, but hard-to-reach places need to be cleaned regularly by Dr. Busch to ensure all plaque build up is removed.
After receiving treatment for periodontal disease, it's very important to receive regular maintenance cleanings from a dentist or hygienist. These cleanings will provide Dr. Busch the perfect opportunity to check the sulcus and ensure that your teeth and gums are healthy. Plaque and tartar that haven't been removed by your daily cleaning efforts will be taken care of during this cleaning. You should schedule these check ups about four times a year.
Your periodontal cleaning and examination will also include:
- Examination of diagnostic x-rays
- Examination of existing restorations
- Examination of tooth decay
- Oral cancer screening
- Oral hygiene recommendations
- Teeth polishing
Regular periodontal cleanings combined with good oral hygiene habits will help you to maintain good dental health, and they are effective preventive measures against the return of periodontal disease.
Most Americans dread going to the dentist. At Old Greenwich Detal Associates, we understand and will help alleviate your fears. Our experienced sedation dentistry team will give you the dream smile you deserve in only one or two pain and anxiety free appointments. Don't be discouraged by past dental experiences; our experienced staff will work with you to create the smile you won't want to hide again!
Cosmetic Dentistry - Composite Fillings
Composite fillings are tooth-colored fills that are used to repair a tooth that has experienced some type of damage, whether it be decay, a chip or something else. Once the flawed part of the tooth is removed, the composite filling is used to fill up the tooth, giving it back its original form.
Composite fillings are only one of the many filling options that are available for restorations. Each option has its own benefits and drawbacks, and Dr. Busch would be the best one to discuss the different options with you. Composite fillings can be very closely matched to a tooth's existing color and are therefore more appropriate for front teeth or other visible teeth.
Composite fillings are very durable, lasting for several years, but they most likely will have to be replaced after time.
Reasons for composite fillings:
- Chipped teeth
- Closing a gap between two teeth
- Cracked or broken teeth
- Decayed teeth
- Worn teeth
- Removing silver
How are composite fillings placed?
Composite fillings can typically be done or placed in one appointment. After numbing the tooth, Dr. Busch will remove decay and other damaged areas. Before placing the new filling, the new space will be thoroughly cleaned. Special medication is applied to teeth that have decay near the tooth root. After this prep work, the composite filling will be placed, shaped and polished, and your tooth will once again have its original shape and function.
After first receiving a composite filling, you are likely to be sensitive to hot and cold. Once your tooth acclimates to the new filling, this sensitivity will go away.
Dr. Busch or hygienist will provide you with care instructions when the procedure is finished. Keeping up good eating habits, regular dental visits and a consistent home dental routine will help extend the life of your fillings.
Cosmetic Dentistry - Porcelain Crowns (Caps)
A crown encloses the entire surface of a tooth, giving it back its original size, shape and function. Also referred to as a cap, a crown is used to protect a tooth that cannot be helped by other restorations, such as fillings.
Many different materials can be used for crowns, but porcelain crowns are by far the most popular, as their color resembles that of natural teeth. Like most restorations, these types of crowns are very durable over the years, but they will need replaced after a while. Porcelain crowns help restore your smile by bringing back the original shape, color and size of your tooth.
Reasons for crowns:
- Broken or fractured teeth
- Cosmetic enhancement
- Decayed teeth
- Fractured fillings
- Large fillings
- Root canals
What does getting a crown involve?
Crowns typically require two appointments, with the first appointment being used to take molds/impressions to create a custom crown for your tooth. We will also create a temporary mold at that time, and this mold will stay on your tooth until the crown has been made by the dental laboratory. Normally, this is a two-week time lapse.
Dr. Busch will prepare your tooth for the crown by first numbing it and then removing decay so the crown can fit properly. After this prep work is done, the temporary crown will be attached using a temporary cement. At this time, we will also check to make sure you still have a comfortable bite with the temporary crown.
The temporary crown will be removed at your second appointment. The tooth will be cleaned again, and Dr. Busch will place the new crown, making sure that your bite and the spacing are accurate.
Instructions will be provided on how to care for your new crown, and regular dental visits will help ensure that it stays in good shape.
Cosmetic Dentistry - Porcelain Fixed Bridges
Dental bridges are permanent dental restorations that are used to replace missing teeth.
As with almost all restorations, there are many types of bridges that you can choose from, though Dr. Busch can help you make the best choice. The most traditional bridge, which consists of porcelain fused to metal, is also the most popular, mainly because porcelain resembles the natural color of teeth. With this type of bridge, two crowns are placed over two anchoring (abutment) teeth, and they are attached to artificial teeth (pontics), thereby filling the gap created by a missing tooth or by missing teeth.
Dental bridges will last for several years, but they might require replacement or need to be re- cemented due to normal wear over time.
Reasons for a fixed bridge:
- Fill space of missing teeth
- Maintain facial shape
- Prevent remaining teeth from drifting out of position
- Restore chewing and speaking ability
- Restore your smile
- Upgrade from a removable partial denture to a permanent dental appliance
What does getting a fixed bridge involve?
Getting a bridge usually requires two or more visits. While the teeth are numb, the two anchoring teeth are prepared by removing a portion of enamel to allow for a crown. Next, a highly accurate impression (mold) is made. This will be sent to a dental laboratory where the bridge will be fabricated. In addition, a temporary bridge will be made and worn for several weeks until your next appointment.
At the second visit, your permanent bridge will be carefully checked, adjusted, and cemented to achieve a proper fit. Occasionally, Dr. Busch may cement the bridge temporarily, allowing your teeth and tissue time to get used to the new bridge. The new bridge will be permanently cemented at a later time.
You will receive care instructions at the conclusion of your treatment. Proper brushing, flossing and regular dental visits will aid in the life of your new permanent bridge.
Cosmetic Dentistry - Porcelain Veneers
Veneers are custom-made pieces of tooth-shaped porcelain. They are very thin and created by a professional dental laboratory. Veneers are bonded to the front of the teeth, creating a beautiful smile.
Veneers can be used to transform your smile, and they are often an alternative to crowns for many different situations.
Just like other dental restorations, veneers are very durable, but they may need replaced over time so you can keep your smile looking its absolute best.
Reasons for porcelain veneers:
- Cosmetically, to create a uniform, white, beautiful smile
- Crooked teeth
- Misshapen teeth
- Severely discolored or stained teeth
- Teeth that are too small or large
- Unwanted or uneven spaces
- Worn or chipped teeth
What does getting porcelain veneers involve?
Two visits to Dr. Busch are typically necessary for receiving veneers. Dr. Busch will prep your teeth by lightly buffing and shaping them so there is room for the thickness of the veneer. Little or no anesthesia is necessary for this process. During this first appointment, Dr. Busch will also take a mold of your teeth and will help you choose the appropriate color/shade.
When you come in for the second visit, your teeth will be cleansed to ensure a long-lasting bond. After this cleansing, a bonding cement is applied between the tooth and the veneer, and a special light beam is used to harden and set the bond.
Careful and regular flossing, brushing and dental visits are necessary to increase the life of your veneers. You will receive basic care instructions after the procedure is finished.
Cosmetic Dentistry - Tooth Whitening
Tooth whitening is used to brighted the natural color of the tooth enamel, and it is an easy, non-invasive way to improve the appearance and beauty of your smile in about one hour.
Touch ups every several years are necessary to keep your teeth looking white. People who smoke or drink coffee, tea or wine will need touch ups more frequently
Reasons for tooth whitening:
- Normal wear of outer tooth layer
- Stained teeth due to medications (tetracycline, etc.)
- Yellow or brown-stained teeth
What does tooth whitening involve?
Getting you set up with the right home tooth whitening system takes two visits. The first visit is used to take impressions of your teeth in order to create clear, plastic trays for you.
At your next appointment, we'll check to see that the trays fit properly and then make any necessary adjustments. You'll wear these trays either twice a day for 30 minutes or overnight for a couple of weeks. The length of the treatment depends largely on how white you want your teeth to get and what the current level of staining on your teeth is. After your whitening treatment, it is typical for your teeth to be more sensitive than normal, but this sensation will subside.
In addition to the trays and solution, you will also receive care instructions to help ensure the your smile stays healthy and white.
With the Invisalign system, uncomfortable and unsightly metal braces are no longer necessary for a beautiful, straight smile. This system consists of a series of clear aligners that are custom-made for each patient. The end result is a comfortable fit that gradually straightens your teeth. Over half a million people have opted for this convenient, easy system.
As a lumineers provider, I can give you the look you've always wanted. Lumineers can be made as thin as a contact lens.