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• Sedation Dentistry
• White Fillings
• Crowns
• Root Canals
• Bridges
• Partial Plates
• Dentures
• Digital X-Rays
• Checkup
• Periodontal Disease
• Bad Breath
• Extractions

• invisalign®
• Braces

• Lumineers®
• Veneers
• Implants
• Mini-Implants
• Whitening
• Bonding
• Crowns
-• Bridges


What are the benefits?

 Oral conscious sedation helps certain patients cope more comfortably with dental appointments.

 We may recommend it if you are anxious about dental appointments, have difficulty getting numb with local anesthesia, have a severe gag response, suffer from very sensitive teeth, or want to have a lot of dental work done during a single, longer appointment.

 To plan the best treatment for you, we'll need to know about your current medical conditions and medications, along with any allergic reactions you've had to other medications.

 What to expect

 First, we may ask you to abstain from all foods and liquids for 12 hours, and then you'll take an oral medication about an hour before your appointment. Because the medication will make you groggy, you'll need a friend or relative to bring you to the office.

 Once you're seated in the chair, we'll assess how deeply you're sedated, and adjust your medication if necessary to keep you comfortable. For most procedures, it will also be necessary to numb your mouth, but the oral medication you've taken will make this pain-free.

 During the procedure, we'll constantly monitor your pulse, blood pressure, and oxygen levels to ensure your safety. You won't feel any pain or be aware of time passing during the procedure. You'll feel very relaxed and may even sleep, but you will respond easily to touch and our requests.

 Recovery is a Dream

 When your treatment is complete you may be a bit wobbly, so your companion will take you home and stay with your until you're recovered. You'll be amazed at how much you can be accomplished in such a seemingly short period of time, while you are totally relaxed, and completely comfortable. And best of all, the next day you will feel fantastic.

 Hours Will Seem Like Minutes

 Fortunately, sedation medications have an amnesic effect. That means you'll have very little, if any, memory of the sights, smells or sounds or your visit.

 I'm nervous! What are the EXACT STEPS to the sedation process?

 Step 1

Making your first appointment

This is difficult for many anxious people, so we try to make this as easy as possible.

 Step 2

Welcoming visit

We gather information regarding your health and discuss with you your wants and desires. If you're comfortable, we'll take x-rays and look in your mouth. But you will never be judged or embarrassed.

 Step 3

Preparing for your sedation visit

We'll give you a prescription for a sedative to take the night before your first appointment to guarantee a good night's sleep and to make sure you wake up relaxed.

 Step 4

Arriving for Treatment

Your companion will bring you to the office. Additional medications will be provided to create the ultimate in relaxation. Your experienced sedation team will monitor you throughout your entire visit.

 Step 5

Going home with your new smile

Your companion will take you home and stay with you until you're completely recovered from your sedation medication.

 Step 6

The next day

Most patients fell no discomfort or residual effects from the dental visit and you'll be thrilled with all the compliments you will get.

 Call us today at (513) 825-6111 to make an appointment.

For many, oral conscious sedation is a good choice for anxiety-free dentistry.


White Fillings

Until recently, silver amalgam was the material most often used to restore decayed portions of your teeth, especially back teeth. Unfortunately, silver fillings can really darken a smile, and amalgam, by its very nature, can cause damage to your tooth in the long run.

Amalgam fillings absorb moisture and expand and contract with heat and cold. So, as the filling ages, it can fracture your tooth;we’ll then need to place a crown on your tooth to save it. Also, silver fillings often undergo metal fatigue, corroding and leaking over time. This destroys the protective seal of the filling and allows new decay to develop underneath it. This leakage can give a gray appearance to the entire tooth.

New tooth-colored options

Dental research has resulted in the development of new tooth-colored materials that are not only durable and long lasting, but attractive as well. These materials, porcelain and composite resin, provide an attractive, natural look while at the same time restoring strength and durability to your tooth.

Both porcelain and composite resin are bonded directly to the tooth, restoring it to near its original strength and function. Both can be custom-colored to precisely match your teeth, so when porcelain or resin fillings are placed, they’re extremely natural looking. This can really make a difference in your appearance, especially if the restoration is visible when you smile.

More advantages of white restorations

When we place an amalgam filling, we have to remove extra healthy tooth structure, just so the filling will stay in place. When we restore your tooth with composite resin, we need to remove only the decayed portion because the bond anchors the material tightly in place. This means you retain more healthy tooth structure.

Also, because white fillings are bonded to your tooth, they add strength to the tooth.

So if you’re looking for an attractive and effective option for restoring one or more decayed teeth, be sure to ask us about the latest choices in white restorative materials.


All-Porcelain Crowns

A tooth-colored crown may be made of both porcelain and metal, or, thanks to newly available technology, it may be made entirely of porcelain.

Metal and porcelain crowns

In the past, porcelain crowns were always built upon a metal core. That was the only way they could have enough strength to withstand the tremendous biting forces that are exerted on all of your teeth. That metal core is what creates the dark blue line at the edge of many crowns.

The benefits of all-porcelain crowns

Recent breakthroughs in adhesives, combined with the development of stronger porcelain materials, allow us to make crowns entirely out of porcelain. All-porcelain crowns maintain a translucency that makes them hard to tell from natural teeth. Without metal, the problem of a dark line at the edge of the gums is eliminated. This allows us to place the edge of the crown above the gumline, and that’s healthier for your tooth and gums.

When you want to improve your smile, all-porcelain crowns are a beautiful and natural-looking choice.


Root Canals

The visible exterior layer of a tooth is called the enamel. Beneath the enamel is another hard layer, called the dentin. The dentin surrounds a small chamber at the center of the tooth that contains the pulp. Tooth pulp is a soft tissue made up of nerves, arteries, and veins. The pulp extends from the pulp chamber down through narrow channels, called the root canals, to the tips of the roots.

How did my tooth become infected?

The two most common causes of infection in the pulp are deep cavities and fractured or broken teeth. Both expose the pulp to bacteria that live in saliva. These bacteria, which are always present in your mouth, can cause an infection that can kill the pulp. Without treatment, the pus from the infection can eventually gather down at the root tip and pass into the jaw bone, causing an abscess (a pus pocket). The abscess can then damage the bone that surrounds the tooth. The resulting pressure inside the bone and ligaments surrounding the tooth can cause excruciating pain, and left untreated, can even be life threatening.

Symptoms vary

You may have realized that you had an infected tooth because it was sensitive to hot and cold, was swollen and painful, or had given you a bad taste in your mouth. On the other hand, you may have been completely unaware that you had an infection because you experienced no symptoms at all.

Root canal treatment

An infected tooth will never heal on its own, and as it gets worse, it will continue to be a source of infection that depletes your immune system, which can affect your entire body. Years ago, your only option would be for us to
extract the tooth. But today, we can remove the infection with root canal treatment, and save your tooth.


All-Porcelain Bridges

A tooth-colored bridge may be made of both porcelain and metal, or, thanks to newly available technology, it may be made entirely of porcelain.

Metal-and-porcelain bridges

In the past, porcelain bridges were always built upon a metal core. That was the only way they could have enough strength to withstand the tremendous biting forces that are exerted on all of your teeth. That metal core is what creates the dark blue line at the edge of many bridges.

The benefits of all-porcelain bridges

Recent breakthroughs in adhesives, combined with the development of stronger porcelain materials, allow us to make bridges entirely out of porcelain. All-porcelain bridges maintain a translucency that makes them hard to tell from natural teeth. Without metal, the problem of a dark line at the edge of the gums is eliminated. This allows us to place the edge of the bridge above the gumline, and that's healthier for your teeth and gums.

When you want to improve your smile, all-porcelain bridges are a beautiful and natural-looking choice.


Dentures Upper Partial

Advantages of a partial denture

An upper partial denture can be a good way to replace missing teeth. When you save your remaining teeth and have a partial denture, you’ll chew better, look better, and have a healthier mouth. A typical upper partial denture is held in place by metal clasps that fit around the anchor teeth.

A partial denture prevents several problems. By filling in spaces, it prevents neighboring teeth from shifting. If missing teeth aren’t replaced, it can set off a chain reaction that can result in cavities and periodontal disease. A partial also helps balance your bite. This means you’ll chew better and have a healthier jaw joint. Partials also add support to your cheeks and lips. This support is necessary to speak clearly and look your best.

The process

The process of making an upper partial denture involves a series of appointments. Though the process varies in each individual case, it usually involves minor shaping of the teeth followed by impressions. Models are made from the impressions, and it’s on the models that the partial framework and final partial denture are fabricated in a dental laboratory. After several try-ins and adjustments, the partial denture is seated.

Adjusting to your partial denture

Some temporary problems are a normal part of adjusting to a new upper partial denture. At first, it may seem bulky or tip when you chew. You may notice increased salivary flow. Your tongue may feel crowded, and you may gag a little or have difficulty speaking. But don’t worry;as you get used to your new partial, these problems will go away. With time and practice, you’ll make the adjustment and be eating with confidence.


Immediate Dentures

If many of your teeth are loose or painful, it may be too late to save them. In most cases, loose or painful teeth are caused by advanced periodontal disease. Periodontal disease also causes bone loss, and if it’s not caught in time, your teeth may have to be removed because there’s too little support for them. Removing your teeth and replacing them with a denture may be the best way to eliminate the infection caused by periodontal disease and restore the health of your mouth. When this is all done on the same day, it’s called an immediate denture.

The procedure

To begin the process of making a denture, we first take impressions of your mouth. From these impressions, we make precise working models of your mouth, and it’s on these models that we make the denture. We’ll work with you to select the best color and shape for your new teeth. When your denture is ready, we’ll thoroughly numb your mouth and extract your remaining teeth. After your teeth are removed, we’ll immediately place your denture.

What to expect after the procedure

For the first 24 hours, your new denture will feel tight because your gums are swollen. As your bone heals over the next six to nine months, your gums will shrink and your denture will feel loose. When this happens, we’ll use a temporary lining material to tighten the fit. After the period of healing is complete, we’ll either construct an entirely new final denture or send your immediate denture back to the lab to be relined for its final fit.

Adjusting to your new denture

Some temporary problems are a normal part of adjusting to your new denture. At first, it may seem bulky or tip when you chew. You may notice increased salivary flow. Your tongue may feel crowded, and you may gag a little or have difficulty speaking. But on’t worry, as you get used to your new denture, these problems will go away. Like learning any new skill, eating with your new denture will at first feel awkward. But with time and practice, you’ll make the adjustment. Nobody likes to lose their teeth, but when your teeth are infected, removing them and getting an immediate denture can improve your health, smile, and confidence.


Digital X-ray Technology

Digital radiography

Until recently, our only option when taking a dental x-ray was the exposure of a small film packet, which then took between five and ten minutes to develop. Now, the digital era has brought us an exciting new technology called digital radiography.

The advantages of digital radiography

Digital radiography has many advantages over traditional dental x-rays:

• It’s faster.
• We can view images instantly.
• There is up to 80 percent less radiation.
• We can enhance images in a variety of ways to improve viewing.
• Images can be stored electronically for instant retrieval in the future, if needed.
• We avoid the chemicals used in the traditional developing process.

How digital radiography works

With digital radiography, we use a small sensor connected directly to a computer instead of a film packet. Taking x-rays is faster because the sensor is merely moved from tooth to tooth;we don’t need to reload a film positioner for each image. It’s also faster because the x-rays are available immediately on the computer monitor, with no development step in between. Because the sensor is more sensitive than conventional x-ray film, the amount of x-ray radiation is reduced by up to 80 percent.

Digital x-rays allow us to see details and make adjustments that are a tremendous help in our diagnosis. We can also save images in our computer system for instant retrieval at a later date.

Digital radiography is an advanced technology that speeds treatment and helps us make the most accurate and efficient diagnosis of your dental condition.


Check Up

Importance of Regular Exams

Because of our commitment to preventive dental care, we recommend a checkup every six months. Most dental problems start small, but then they go through a rapid growth phase. Regular checkups enable us to catch these problems before they become serious conditions:

• Plaque buildup
• Gingivitis
• Cavities
• Cracked or leaking fillings
• Bad bite

Serious conditions begin as treatable problems

Plaque, which is a sticky film of food and bacteria that forms constantly on your teeth, can harden in as little as 24 hours to become tartar. Even with proper brushing and flossing, most people aren’t able to remove all the plaque every day. The result is tartar buildup.

Plaque and tartar buildup are the main cause of gingivitis, which is an inflammation that makes gums swell and bleed. Gingivitis is reversible, but if it’s not treated, it can lead to periodontal disease, which is an infection that causes receding gums, bone loss, and sometimes tooth loss.

The bacteria in plaque also cause tooth decay. A small cavity can easily be fixed, but if it grows into the softer inner dentin layer of the tooth, it can reach the pulp chamber very quickly, causing pain and further infection.

Failed fillings can also lead to more decay. Unless it’s treated early, decay will most likely lead to a need for root canal treatment and crowns.

Misaligned or missing teeth can contribute to problems with the jaw joint, such as pain and soreness, difficulty in opening and closing your mouth, and earaches.

Regular checkups allow us to treat problems early

To keep these dental problems from becoming serious, we recommend twice yearly checkups. Regular cleanings enable us to keep tartar from accumulating on your teeth. During your regular visits, we will also perform a thorough exam to check your gums, measure the bone levels around your teeth, look for cavities, check your restorations, and examine your bite.

Regular exams are the best way to eliminate the growth phase of dental problems, and minimize the time and money you spend in the dental chair. We check for any changes

The Hygienist

A dental hygienist is a highly trained and licensed oral health professional who provides you with educational, clinical, and therapeutic services to enhance your oral and overall health.

Hygienists’education and training

Hygienists receive intensive, specialized education and training, which includes courses in chemistry, head and neck anatomy, physiology, biochemistry, microbiology, pathology, nutrition and pharmacology, as well as courses in advanced dental sciences and dental hygiene.

Prior to graduation, hygienists must complete hundreds of clock hours of supervised instruction in clinical practice.

What hygienists do

Hygienists serve several functions in the dental office. They check for and treat many dental conditions. They also clean your teeth, use specialized tools and techniques, and educate patients.

A hygienist will carefully examine your teeth, mouth, and gums, and pre-screen for any signs of decay, periodontal disease, or other problems.

As part of the preventive function of the hygienist’s job, she will thoroughly clean all surfaces of your teeth, removing plaque, tartar, and stains from above and below your gumline.

During your dental cleaning, your hygienist will use floss, special cleaning compounds, and instruments specifically designed to clean your teeth effectively and comfortably, like ultrasonic cleansers and rotary instruments. She may be involved with the specialized treatment of advanced periodontal disease, such as scaling and root planing. Your hygienist may apply fluoride gels or other treatments.

She also takes and develops dental x-rays so the dentist can view them and quickly diagnose any problems that may exist.

Your hygienist will teach you how to effectively care for your teeth at home to help you prevent decay and periodontal disease, show you how to select the proper toothbrush and dental floss, and demonstrate the most effective techniques for brushing and flossing.

Your hygienist may also explain the relationship between a healthy diet and dental health, offering suggestions about which foods to select and which to avoid. Preventing gum disease.


Diagnosing Periodontal Disease

What is periodontal disease?

Periodontal disease is an infection of the teeth, gums, and the bone that surrounds the teeth, and it’s the leading cause of adult tooth loss. Stopping this condition begins with a thorough diagnosis.

What causes periodontal disease?

The main cause of periodontal disease is the accumulation of plaque, the sticky film of food and bacteria that forms constantly on your teeth.

If plaque isn’t removed each day, the bacteria in plaque invade the spaces between the teeth and gums and begin producing toxins. These toxins, combined with your body’s reaction to them, destroy the bone around your teeth. And once bone has been lost, it never grows back on its own.

When too much bone is lost, there’s so little support for the teeth, they get loose and have to be removed.

The warning signs

If you have periodontal disease, you may be experiencing persistent bad breath, bleeding of the gums when brushing or flossing, soft, swollen, or tender gums, gums pulling away from the teeth, or loose teeth. You may also notice inflammation of the gums between the teeth. This is where periodontal disease usually starts.

It is also possible to have no noticeable symptoms. In fact, most people who have periodontal disease aren’t even aware of it.

Diagnosis and treatment

To find periodontal disease, we perform a thorough examination with a periodontal probe and x-rays. Periodontal probing measures the depth of the space between your teeth and gums. When you have periodontal disease, these spaces are called pockets. We measure the pocket from the bottom of the pocket, where it’s attached to the tooth, to the top of the gums. A probe reading of more than three millimeters is a sign of periodontal disease. In general, the deeper the pockets, the greater the spread of periodontal disease.

Gums sometimes bleed during probing. This is also a sign of infection.

X-rays tell us a lot about periodontal disease. As periodontal disease progresses, x-rays will show that jawbone levels have become uneven, and that bone has receded away from the necks of the teeth.

Once we’ve found periodontal disease, we’ll talk with you about treatment options and proper homecare to minimize bone loss and restore the health of your gums.


Bad Breath

What causes bad breath?

Bad breath, also known as halitosis, is often easily treatable. There are several causes of bad breath:

• Strong foods like garlic and onions

• Smoking

• Periodontal disease

• Dry mouth

• Various medical conditions

• Improper or inconsistent dental homecare

Treating bad breath

Eliminating the bacteria found on your tongue and gums is one of the first steps in getting rid of bad breath. The tongue surface is made up of many tiny fissures. Small particles of food can get trapped in these fissures and begin to decompose. A type of bacteria, called anaerobic bacteria, thrives in these areas, where there is little or no oxygen. Bad breath odor occurs when these bacteria produce a common compound called sulfur.

Periodontal disease, or gum disease, is another source of sulfur-producing bacteria. The plaque and tartar that build up around your teeth and gums create pockets that trap food and bacteria, and create an environment where sulfur is produced. It’s fortunate that the treatment of periodontal disease will also help treat the bad breath symptoms.

When we treat bad breath, we first remove the sulfur-producing bacteria from your mouth during a professional cleaning.

If your bad breath was caused by dry mouth, we’ll investigate the causes and suggest treatment options. We’ll also let you know if we discover signs of any medical conditions.

Next, we’ll work with you to set up a homecare routine that will include daily brushing and flossing, and may also include tongue cleaning and an anti-bacterial rinse. We may also suggest several return appointments to monitor your success and fine-tune your efforts.

Bad breath is uncomfortable and embarrassing, but the good news is that with the right tools, regular care in our office, and the proper homecare routine, it’s reversible. With treatment, you’ll notice improvement right away, and soon be enjoying fresh breath and a healthier mouth.


Hard Tissue Laser

Lasers have been used for many years in dentistry, but recent breakthroughs have allowed us to use lasers on teeth.

The benefits of hard tissue lasers

Because lasers use steady and concentrated light to remove unhealthy tooth structure, they have several advantages over the traditional dental drill. • Less heat is produced, so there is a reduced need for traditional anesthetic.

• It’s quieter and vibrates less.

• Tooth reduction is kept to a minimum.

• The laser creates a highly effective bonding surface on the tooth.

• Without anesthetic, we can work in multiple areas of your mouth in a single visit.

How we use hard tissue lasers

Because the laser is very bright, we first provide you with special glasses to shield your eyes. We then carefully move the laser over the damaged or decayed portion of your teeth. We use a water spray to cool the teeth we are treating. After preparation, teeth are usually restored with one of the new white filling materials that can be bonded to the teeth. With the hard tissue laser, we can repair cavities and prepare teeth for bonding. It allows us to remove the smallest amount of tooth structure and place strong, natural-looking restorations in the shortest amount of time.


Extracting a SingleTooth

Removing a tooth is sometimes necessary to preserve the health of your mouth and remaining teeth. With modern dental techniques, it should be a comfortable and effective procedure.

When tooth extraction is needed

Generally, we recommend treatments that will save teeth, but when a tooth is so damaged that it cannot be saved, extraction is the best choice.Extraction might be best for:

•Teeth that are fractured below the gumline

•Severe tooth decay

•Advanced periodontal disease

•Primary teeth that are too crowded or not falling out properly

•An impacted wisdom tooth

The procedure

Before we start the extraction procedure, we may offer nitrous oxide to relax you, and we’ll numb the area with anesthetic to keep you comfortable. After several minutes, we check the area to make sure that it’s completely numb.During the procedure, you’ll feel pressure when the tooth is removed, but you shouldn’t feel any pain at all.If you do, we’ll stop and give you more anesthetic.

If the tooth hasn’t yet come in through the gums, we’ll start by making a small incision.To remove the tooth, we’ll use an instrument called an elevator, which is placed next to your tooth and is used to gently loosen it.Then, we use forceps to grip the tooth carefully and remove it.

Sometimes, if your tooth’s roots are curved or are held tightly in the socket, it’s helpful to cut the tooth into sections before removing them.If an incision was necessary, we may close it with a couple of stitches once the tooth is removed.

Taking care of yourself after the extraction

To minimize problems after your tooth is removed, you’ll need to follow our post-operative instructions carefully, especially for the first 24 hours.These instructions will explain how to control bleeding, how to relieve pain, minimize swelling, and prevent dry socket.You’ll also learn what you can and cannot eat.

The benefits of extracting teeth

An extraction is sometimes the best treatment choice for preventing many future dental problems.Depending on your situation, these problems might include the risk of infection, the spread of periodontal disease, cysts in the jawbone, or severely crowded or misaligned teeth.


Copyright © 2005. Patterson Dental Supply, Inc. All rights reserved.

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Located at I-275 and Hamilton Avenue, 2nd Building
11430 Hamilton Avenue, Cincinnati, OH 45231
Fax: (513) 825-5947 -----  Phone: (513) 825-6111

Copyright © 2008 Michael & David Rothan DDS, LLC. DBA Twin Dental - All Rights Reserved.
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