Contact information
Faye E. Licata, D.M.D, F.A.G.D., P.C.
111 Hilltown Village Center Suite 200
Chesterfield, MO 63017
636-532-2101
info@licatadental.com
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Dental Services, Fillings, Whitening, Emergency Work, and more

Click on the links below to find out more information about the types of care Dr. Licata and her staff can provide.

White Fillings
Veneers
Keeping Gums Healthy
Whitening/Bleaching
Cosmetic Smile Makeovers
Treating Bad Breath
Implants
Protective Bite Appliances for Bruxism and TMJ Therapy
Emergency Care
Treatment of Dental Anxiety
Crowns
Bridges
Dentures and Partials
Sealants
Adult Comprehensive Care
Children’s Care
Teen’s Care
Referrals to Specialists
Recare Visits
New Technology


White Fillings

Dr. Licata places only white, tooth-colored fillings for her patients.  She eliminated silver fillings from her practice in the mid 90’s, so she has had many successful years of experience with placing all types and sizes of white fillings.

The tooth-colored plastic and glass mixture used to restore teeth is called a composite filling. Composites are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth.
   
Following preparation, Dr. Licata places the composite in layers, typically using a specialized curing light to harden each layer. When the process is finished, she will shape the composite to fit the tooth. Then she polishes the composite to prevent staining and early wear.
 
Most dental insurance plans cover a portion of the cost of the composite. As composites continue to become more the standard of care throughout the dental profession, more insurance companies are likely to increase their coverage of composites.
 
Aesthetics are the main advantage of composites, since we can blend shades to create a color nearly identical to that of the actual tooth. Composites bond to the tooth to support the remaining tooth structure, which helps to prevent breakage and insulate the tooth from excessive temperature changes.

Veneers

Veneers are ultra-thin shells of ceramic (porcelain) or a composite resin material, which are bonded to the front of teeth. This procedure requires little or no anesthesia and can be the ideal choice for improving the appearance of the front teeth. Veneers are placed to mask discolorations, to brighten teeth and to improve a smile.

Veneers are an excellent alternative to crowns in many situations. They provide a much more conservative approach to changing a tooth's color, size or shape. Veneers can mask undesirable defects, such as teeth stained by tetracycline and damage due to an injury or as a result of a root-canal procedure. They are ideal for masking discolored fillings in front teeth. Patients with gaps between their front teeth or who have teeth that are chipped or worn may consider veneers. Generally, veneers will last for many years, and the technique has shown remarkable longevity when properly performed.

Patients may need up to three appointments for the entire procedure: diagnosis and treatment planning, preparation and bonding.

It's critical that you take an active role in the smile design. Spend time in the planning of your smile. Understand the corrective limitations of veneers. Have more than one consultation with us, if necessary, to feel comfortable that we understand your objectives.

To prepare the teeth for the veneers, the teeth are lightly shaped to allow for the added thickness of the veneer. Usually, about half a millimeter of the tooth is removed.  Usually no anesthetic is needed, but sometimes a veneer shaping may require a local anesthetic. Composite resin veneers are generally done in one appointment. After the tooth is prepared, Dr. Licata carefully bonds and sculpts the composite material onto your teeth. For ceramic veneers, a mold is taken of the teeth, which is sent to the laboratory for the fabrication of the veneers. This may take several days. If the teeth are too unsightly, a temporary veneer can be placed, at an additional cost.

When your ceramic veneers are ready, the dentist places each veneer on the teeth to check their fit and get a sense of the shade or color. While the veneers are resting on your teeth, view the results, and pay particular attention to the color. At this point, the color of the veneers can still be somewhat adjusted with the shade of the cement to be used. The color cannot be altered after veneers are cemented. To apply the veneer, the tooth is cleansed with specific chemicals to achieve a bond. Once a special cement is sandwiched between the veneer and tooth, a light beam hardens the cement.

For about a week or two, you will go through a period of adjustment as you get used to your "new" teeth that have changed in size and shape. You will continue to brush and floss daily as you always have.
 
Veneers are reasonable facsimiles of natural teeth, not perfect replacements. It's not uncommon to see slight variations in the color of veneers upon close inspection, as this occurs even in natural teeth. Nevertheless, this procedure can greatly enhance your smile and can heighten self-esteem.

Keeping Gums Healthy

Everyone knows to brush their teeth twice a day, but many people forget about their gums! The thought of gum disease sounds scary—and it can be if you don’t take care of your gums. Here is some information about what gum disease is, what causes it, and how you can prevent it.

What is periodontal (gum) disease?
Periodontal means “around the tooth.”  Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed. Gingivitis is the mildest form of the disease. In this stage, the gums redden, swell, and bleed easily.  There is usually little or no discomfort.

What causes gum disease?
As mentioned, plaque is recognized as the primary cause of gum disease. If plaque isn’t removed each day by brushing and flossing, it hardens into a rough, stubborn substance called calculus (also known as tartar). Toxins produced and released by bacteria in plaque irritate the gums. These toxins cause the breakdown of the fibers that hold the gums tightly to the teeth, creating periodontal pockets that fill with even more toxins and bacteria. As the disease progresses, pockets become deeper, and the bacteria move down until the bone that holds the tooth in place is destroyed.  Eventually, severe infection may develop with pain and swelling. The tooth may loosen and later require removal.  There are other factors, too. Smokers and tobacco users are at a higher risk of developing gum disease. Changing hormone levels in pubescent teenagers and women who are pregnant also can increase the risk of gum disease. Stress, clenching or grinding your teeth, an unhealthy diet, and diabetes can increase your chances of developing gum disease as well. And, in some cases, it’s in your genes—nearly 30 percent of the human population is genetically predisposed to gum disease.

How is it treated?
In the early stages of gum disease, most treatment involves a special cleaning called scaling and root planing, which removes plaque and tartar around the tooth and smooths the root surfaces. Depending upon how severe the gum disease is, the treatment for scaling and root planning can take one, two, or sometimes up to four appointments to complete.  Antibiotics or antimicrobials may be used to supplement the effects of scaling and root planing.   In our office, after scaling and root planing we will irrigate the pockets of your gums with a liquid medicine, and we will also often place an antibiotic powder in some of the deepest pockets.  This antibiotic powder helps fight the active infection for up the three weeks.  In most cases of early gum disease, scaling and root planning and proper daily cleaning will definitely help. We follow up our progress in the treatment of your disease by evaluating the health of the gums six weeks after the scaling and root planing has been completed.  After that, a three-month recare interval works best for managing your periodontal disease.

 More advanced cases of disease may require surgical treatment, which involves cutting the gums to remove the hardened plaque build-up and then recontouring the damaged bone. The procedure also is designed to smooth root surfaces and reposition the gum tissue so it will be easier to keep clean. These surgical procedures are performed by a specialist called a periodontist, and Dr. Licata will recommend a referral for you if needed.

How can I maintain treatment at home?
Sticking to a maintenance program is crucial for patients who want to sustain the results of periodontal therapy. You should visit Dr. Licata every three to four months for spot scaling and root planing and an overall exam.  Between visits, brush at least twice a day and floss daily.

How can I prevent gum disease?
Removing plaque through daily brushing and flossing and professional cleaning is the best way to minimize your risk. You also should try to reduce the activities mentioned above (smoking, eating an unhealthy diet, grinding your teeth, and so forth). Talk to Dr. Licata and her staff so they can design a personalized program for home oral care to meet your needs.

What if I do nothing about my gum disease?
The eventual result of gum disease is tooth loss.  To replace teeth is expensive and time consuming, and unless implants are chosen to replace missing teeth, the other options for replacement are not as good as the natural teeth you started with.  You will not have the chewing efficiency and comfort as you do with your own natural teeth.  Also, now there are direct links to gum disease causing increased incidences of coronary artery and heart  disease, diabetes, and low birth weight babies.

Whitening/Bleaching

Your wedding is coming up, and you want your smile to be its brightest. Or maybe you have an important speaking engagement. Whatever the reason, tooth bleaching isn't just for movie stars, and it isn't just for one day. Many people have had their teeth bleached, and probably millions more are thinking about it. The desire for a brighter smile with whiter teeth is very strong, and tooth bleaching safely lightens the color of the teeth, lasting for years. The most effective and safest method of tooth bleaching is dentist-supervised.
 
Generally, bleaching is successful in at least 90 percent of patients, though it may not be an option for everyone. Consider tooth bleaching if your teeth are darkened from age, coffee, tea or smoking. Teeth darkened with the color of yellow, brown or orange respond better to bleaching. Gray stains caused by fluorosis, smoking or tetracycline can be lightened, but results are not as dramatic. If you have very sensitive teeth, periodontal (gum) disease or teeth with worn enamel, your dentist may discourage bleaching. Lightness should last many months to a few years, depending on your personal habits such as smoking and drinking coffee and tea. At any point you may choose to get a touch-up. The retreatment time is much shorter than the original treatment time.
 
The active ingredient in most of whitening agents is carbamide peroxide; when water comes into contact with this white crystal, the release of hydrogen peroxide lightens the teeth.
 
Several studies have proven bleaching to be safe and effective. The American Dental Association has granted its seal of approval to some tooth bleaching products. Some patients may experience slight gum irritation or tooth sensitivity, which will resolve when the treatment ends.

First, we will determine whether you are a candidate for tooth bleaching and what type of bleaching system would provide the best results. If you're in a hurry for whiter teeth, you may decide to have your teeth lightened immediately. We can use an in-office bleaching system while you sit in the dental chair. When a patient has in-office bleaching, take- home trays with bleaching gel refills are still needed to continue the whitening process at home. Some patients choose to do only the take-home bleaching, which is more economical and provides similar results in the long run.
 
To make the take-home bleaching trays, we will make impressions of your teeth to create a mouthguard appliance. The mouthguard is custom-made for your mouth and is lightweight so that it can be worn comfortably. The mouthguard is so thin that you should even be able to talk and work while wearing it. Along with the mouthguard, you'll receive the bleaching materials. You'll be given instructions on how to place the bleaching gel and wear the mouthguard.
 
Every bleaching system is different regarding how long the trays are worn with the bleaching gel in them.  Our system needs to only be worn for one hour a day to effectively lighten your smile.  Results are usually seen within the first few days of wearing the take home trays, and most people bleach about 3 or 4 weeks to get their ultimate desired level of whiteness.
 
Over-the-counter bleaching systems are also available and are generally safe and effective, although it is best to check with us before using these products. These systems, which come in the form of strips and gels, usually contain a lower strength of bleaching agent than products used in our office. For this reason, they must be used longer to achieve a desired effect, but they are also less expensive.  We have the Crest White Strips kit available here, and it is a stronger percentage solution than what you can buy yourself at an over-the-counter store.

No one can really predict how much lighter your teeth will become. Every case is different. Typically, there is a two-shade improvement as seen on a dentist's shade guide. The success rate depends upon the type of tooth stain involved, the type of bleaching procedure and your compliance. Bleaching can only provide a shift in color from gray to a lighter shade of gray, for example. Bleaching does not lighten artificial materials such as bonding or veneers.

Cosmetic Smile Makeovers

Dr. Licata can perform a variety of cosmetic procedures to improve your smile—from subtle changes to major repairs. There are many techniques and options to treat teeth that are discolored, chipped, misshapen, or missing. Dr. Licata can reshape your teeth, close spaces, restore worn teeth, or alter the length of your teeth. Common procedures to do this include teeth whitening, bonding, caps, implants, crowns, veneers, and reshaping and contouring.  More information on each of these techniques is available by clicking on these links in this section of our website.  Often a combination of many of these techniques is used to get the best results.

What can I expect at a cosmetic consult?
The most important thing at the consult is to establish a good open line of communication with Dr. Licata and her staff.  Lots of time will be spent discussing your expectations and hopes for what changes you wish to achieve with your smile.  The problems with your smile will be discussed, and the causes of these problems explored.  If underlying problems exist (for instance, debilitative grinding or clenching) that aren’t addressed, it could lead to failure of any new work that would be done.  Ideas will be discussed about what can and cannot be accomplished within your parameters, including physical, emotional, and financial.  A comprehensive x-ray series, exam, and study model impressions will be obtained if you wish to pursue a more in depth analysis of what can truly be achieved to change your smile.  We will enlist the help of our dental laboratory to obtain a “diagnostic wax-up”, where the lab uses your teeth to show us in wax the results we can realistically obtain.  After careful study of all the gathered data, Dr. Licata will provide a written estimate of costs and time needed to complete your custom smile.

What should I look for in a cosmetic dentist?
Dr. Licata is very skilled in cosmetic dentistry, and has had years of experience in changing smiles from one tooth at a time, all the way up to complete full mouth reconstructions.  You might wish to discuss the following things before undergoing treatment:
Before and after photos.These photos will allow you to see some the results of other patients who have been treated by Dr. Licata. Check out just a few of Dr. Licata’s previous patients by clicking on BEFORE AND AFTER PHOTOS.
References. References allow you to get a sense of the quality of care that Dr. Licata provides.
Continuing education. Talk to Dr. Licata about the continuing education courses she takes to keep her up-to-date with the latest techniques in clinical cosmetic dentistry.

Dr. Licata can answer all the questions you have about the techniques available to best improve your smile!

Treating Bad Breath

Halitosis, or bad breath, affects more than 80 million people in the United States. In most cases, people with bad breath aren’t even aware of the problem.  Halitosis has a significant impact both personally and socially, on those who suffer from it. If you think that you suffer from bad breath, we can help determine the source of the odor. If the problem is caused from a systemic (internal) source, such as an infection, we may refer you to your family physician or a specialist to help treat the cause of the problem.

What causes bad breath?
Typically, bad breath originates in your gums and tongue. It is caused by waste from bacteria in the mouth (often the same bacteria that causes gum disease), decayed food particles, other debris in your mouth, and bad oral hygiene. The bacteria and debris produce a chemical sulphur-based compound that causes the unpleasant odor. Bad breath may occur in people who have a medical infection, diabetes, kidney failure, or a liver malfunction. Even stress, dieting, snoring, age, and hormonal changes can have an effect on your breath. Xerostomia (dry mouth) and tobacco also contribute to the problem.

What is morning breath?
Saliva is the key ingredient in your mouth that helps keep odor under control because it helps wash away odor-causing food particles and bacteria. When you sleep, however, salivary glands slow the production of saliva, allowing bacteria to grow inside the mouth, which causes the bad odor, or “morning breath.” To alleviate morning breath, brush your teeth and eat a morning meal. Morning breath also is associated with hunger or fasting. If you skip breakfast, the odor may reoccur—even if you’ve brushed your teeth.

Do certain foods or drinks cause bad breath?
Very spicy foods, such as onions and garlic, and drinks like coffee may be detected on a person’s breath for up to 72 hours after digestion. In addition, certain diets, especially ones that eliminate carbohydrates, increase the chances of halitosis.

How can I control bad breath?
Visit us regularly because dental exams will help rule out any dental concerns and detect any systemic causes. Dental cleanings also help to get rid of the plaque and bacteria that build up on your teeth.  It is important to practice good oral hygiene at home, including brushing and flossing your teeth at least twice a day to remove bacteria, plaque, and food particles. To alleviate odors, clean your tongue with your toothbrush or a tongue scraper (a plastic tool that scrapes away bacteria that builds on the tongue). In addition, be sure to drink plenty of water. Try chewing sugar-free gum that contains xylitol—it also may help control odor. If you have dentures or a removable appliance, such as a retainer or mouthguard, clean the appliance thoroughly before placing it back in your mouth. Before you use over-the-counter mouthrinses or deodorizing sprays or tablets, talk with us, because some of these products do little to eliminate bad breath. Instead, we can recommend a special, alcohol-free rinse available in our office that helps eliminate bad breath by specifically targeting the sulphur-producing bacteria which is the primary cause of bad breath.

Implants

When people lose or break their teeth, the teeth may be replaced with implants.  Implants are now considered the “standard of care” and are proven to be a successful, comfortable and effective way to replace missing teeth.  What’s involved, and what are the benefits? Read on to learn more.

What are implants?
Dental implants are artificial tooth roots that are surgically anchored in the jaw to hold a replacement tooth or bridge in place. One of the major benefits of implants is that they do not rely on neighboring teeth for support and they are permanent and stable. Implants are a good solution to tooth loss because they look and feel like natural teeth.

What are implants made of?
Implant material is made from different types of metallic and bone-like ceramic materials that are compatible with body tissues. Most implants are made of titanium, which bonds well with bone and is biocompatible, making it an ideal material for implants.

How are implants placed?
First, a surgeon will perform surgery to place the implant’s anchor in the jaw.  After the implant is placed, it takes anywhere from two to six months for the jaw bone to grow around the anchor to hold it firmly in place. Once the implant is stable and the gums have healed, Dr. Licata makes the artificial teeth and fits them to the post portion of the implant. Dr. Licata will work with you to create an implant that fits well and is comfortable and attractive.

Who places the implants?
While some general dentists will do the surgical placement of implants in the bone, Dr. Licata does not.  She refers to surgical specialists (oral surgeons and periodontists) in the area who place the implants, then Dr. Licata does the restoration process of placing the teeth on the implants.  Dr. Licata works closely with these specialists to assure that the end results meet your needs and expectations.

Who should get implants?
Implants are not an option for everyone. Because implants require surgery, patients must be in good health, have healthy gums, and have adequate bone structure to support the implants. While lack of adequate bone support is a limitation, additional procedures maybe available to create a good implant site. People who are unable to wear dentures also may be good candidates. The success rate for implants decreases dramatically among those who suffer from chronic problems, such as clenching or bruxism, or systemic diseases, such as diabetes. Additionally, people who smoke or drink alcohol may not be good candidates. For more information, talk to Dr. Licata or her staff.

What is the difference between implants and dentures?
While implants are permanently fixed in the mouth, dentures are removable. A conventional removable full denture depends upon support from the bone and soft tissues rather than being solidly fixed in place; as a result, dentures may not offer as much stability as implants.  Some people now choose to have two or four implants placed in their jawbone to provide stability and hold of their dentures, where they might have “floated” all around before.

How do I care for implants?
Poor oral hygiene is a main reason why some implants fail. It is important to floss and brush around implants at least twice a day. Dr. Licata and her staff will give you specific instructions on how to care for your new implants. Additional dental cleanings (up to four times per year) may be necessary to ensure that you retain healthy gums.

How will I adjust to implants?
Most people adjust to implants immediately; however, some people feel slight discomfort and notice differences in chewing or speech for a short time. Patients will soon see a difference in their confidence level and enjoy their new smile.

Protective Bite Appliances for Bruxism and TMJ therapy

What is Bruxism?
One of the main reasons people need a protective bite appliance is due to a phenomenon called bruxism.  Bruxism is the technical term for teeth grinding and clenching that causes facial pain. People unintentionally bite down too hard at inappropriate times, such as in their sleep. In addition, people who brux may also may bite their fingernails, pencils and chew the inside of their cheek. People usually aren’t diagnosed with bruxism until it is too late because so many people don’t realize they have the habit. Others mistakenly believe that their teeth must touch at all times; in reality, at rest our teeth should not touch, but have a few millimeters of space between them.

Who suffers from bruxism?
Bruxism is often triggered by people with certain types of personalities. They may have a nervous tension and a hard time handling stress. Anger, pain and frustration can cause people to start showing the beginning signs of bruxism without them even knowing it. People who are aggressive, competitive and hurried also may be at a greater risk for bruxism.

What can be done?
Dr. Licata checks for physical signs of bruxism and if it seems to be present the condition may be observed over several visits before recommending and starting therapy. The objective of therapy is to get the bruxer to change behavior by learning how to rest the tongue, teeth and lips properly. While simply becoming aware of the problem and changing their behavior may be enough for some people, others will have to wear a plastic mouth appliance, such as a night guard, that’s worn to absorb the forces of biting. This appliance can prevent future damage to the teeth and helps change the patient’s destructive behavior. Biofeedback can be used on daytime grinders by using electronic instruments to measure muscle activity and to teach patients how to reduce muscle activity when the biting force becomes too great. Researchers are still experimenting with new ways to help those who tend to clench in their sleep.

What if bruxism goes untreated?
If a person continues to brux their teeth, eventually the enamel of the teeth is damaged.  It can wear thin on the biting tips of the front and back teeth and cause sensitivity to sweets and cold and hot foods and drinks.  Bruxism can also cause erosion of the necks of the teeth at the gum line areas due to the heavy forces that are transmitted through the teeth.  Bruxism can also be the source of problems and pain associated with the temporomandibular joint (TMJ).

What is the Temporomandibular Joint?
The temporomandibular joint (TMJ) is a joint that slides and rotates just in front of your ear, consisting of the temporal bone (side of the skull) and the mandible (lower jaw). Chewing muscles connect the lower jaw to the skull, allowing you to move your jaw forward, sideways and open and close.
 
The joint works properly when the lower jaw and its joint (both the right and left) are synchronized during movement. Temporomandibular joint disorder (TMD) may occur when  the muscles controlling the jaw become stressed or fatigued, as during bruxing.  TMD can also occur when the jaw twists during opening, closing or side-motion movements. These movements affect the jaw joint and the muscles that control chewing.

Temporomandibular joint disorder (TMD) describes a variety of conditions that affect jaw muscles, temporomandibular joints and nerves associated with chronic facial pain. Symptoms may occur on one or both sides of the face, head or jaw, or develop after an injury. TMD affects more than twice as many women than men.

How to Treat TMD
The majority of cases can be treated by unloading (resting) the joint, taking a non-aspirin pain reliever and practicing stress management and relaxation techniques. Most treatment for TMD is simple, often can be done at home, and does not need surgery. For example, control clenching or grinding during the day by sticking your tongue between your teeth. Control bruxing at night by wearing a protective appliance.  Eating soft foods, avoiding chewing gum, avoiding caffeine, and resting your jaws with limited movement also help relax the muscles.

Most people will experience relief with minor treatment. More severe cases may be treated with physical therapy, ice and hot packs, posture training and appliance therapy. When necessary, stronger pain or anti-inflammatory medications, muscle relaxants or antidepressants may help ease symptoms.

Symptoms of TMD

  • Jaw pain or soreness that is more prevalent in the morning or late afternoon
  • Jaw pain when you chew, bite or yawn
  • Clicking when opening and closing your mouth
  • Difficulty opening and closing your mouth
  • Locked or stiff jaw when you talk, yawn or eat
  • Sensitive teeth when no dental problems can be found
  • An earache without an infection

Is TMD Permanent?
The condition is often cyclical and may recur during times of stress, good or bad. As the patient, you should be active in your treatment by being aware of the causes of your jaw problems after seeing us for a diagnosis regime. Make routine dental appointments, so your doctor can check TMD on a regular basis.

Emergency Care

There is never a good time for a dental problem to occur!  If you find yourself having a dental emergency during regular office hours, we will see you that day to help you with your problem.  If you have an emergency while we are away from the office, our answering machine will have Dr. Licata’s emergency contact number for you to call.

People risk breaking their teeth or otherwise injuring their mouths while eating, playing, exercising, and participating in other seemingly harmless activities. It’s important to understand what to do in case of a dental emergency so that your tooth can be repaired when you are able to see Dr. Licata.

What are dental emergencies and how can I avoid them?
Dental emergencies can occur when your tooth or filling breaks, cracks, becomes loosened, or is knocked out completely. Sometimes crowns come off of teeth. Lips, gums, or cheeks can be cut.  One way to prevent dental problems is to adhere to a faithful recare schedule with Dr. Licata’s office.  If you receive routinely scheduled exams and cleanings, often dental problems can be detected while they are small and easy to fix, instead of waiting for something to break or cause a problem at an inconvenient time.
Dental emergencies can also be avoided by taking simple precautions, such as wearing a mouthguard during sports activities to prevent teeth from breaking or being knocked out, and avoiding hard foods that may crack or break your teeth—whether you have your natural teeth or you wear dentures.  It is also helpful to not use your teeth as tools—never use your teeth to tear or pry things open or remove tags from clothing, etc. Oral injuries can be painful and need emergency care quickly. 

What should I do if a tooth is knocked out?
If your tooth is knocked out, immediately call Dr. Licata for an emergency appointment. It is important to see us within an hour of when your tooth is knocked out for the best chance of the tooth surviving the trauma. Handle the tooth by the crown (the top), not by the root (the pointed part on the bottom).  Touching the root of the tooth can damage cells that are necessary to reattach the tooth to the bone. Gently rinse the tooth in water to remove dirt. Do not scrub the tooth! Place the clean tooth in your mouth between the cheek and gum to keep it moist. It is important not to let the tooth dry out. If it is not possible to store the tooth in the mouth, wrap the tooth in a clean cloth or gauze and immerse it in milk or saline solution (the solution used for contacts). If a baby tooth is knocked out, the tooth should not be replanted. The patient should be seen as soon as possible to make sure there are no remaining pieces of the tooth.

What should I do if my tooth is pushed out of position?
If your tooth is loosened and pushed out of position, call Dr. Licata right away for an emergency appointment. In the meantime, attempt to reposition it to its normal alignment using very light finger pressure—but don’t force it!

How should I handle a chipped or fractured tooth?
There are different types of tooth fractures.  Chipped teeth are minor fractures. Moderate fractures include damage to the enamel, tissue, and/or pulp. Severe fractures usually mean that a tooth has been traumatized to the point that it cannot be recovered.  If you fracture a tooth, rinse you mouth with warm water and use an ice pack or cold compress to reduce swelling.  Take ibuprofen, not aspirin, for pain. Dr. Licata can smooth out minor fractures with a sandpaper disc. Alternatively, restorative procedures like fillings or crowns may be needed to fix the tooth. 

If you wear dentures and a tooth breaks or chips, wear your spare dentures until you can visit Dr. Licata. If you do not have a spare set or cannot get to our office soon, use cyanoacrylate (heavy-duty, quick-drying “super” glue) to glue the tooth or the piece of the tooth back into place. Remember—this is only a temporary measure until we can properly repair your tooth and should only be used for dentures! Never attempt to glue a natural tooth or part of a natural tooth back into place!

What should I do if the tissue of my mouth is injured?
Injuries inside the mouth include tears or cuts, puncture wounds, and lacerations to the cheek, lips, or tongue. The wound should be cleaned immediately with warm water, and the injured person should be taken directly to an oral surgeon for emergency care. If you can’t get to an oral surgeon, the patient should be taken to the hospital. Bleeding from a tongue laceration can be reduced by pulling the tongue forward and using gauze to place pressure on the wound.

Treatment of Dental Anxiety

Patients become anxious about going to the dentist for different reasons. This may include fear of receiving local anesthetic or concerns about the effectiveness of the anesthesia. Negative past experiences also may play a large role in a patient’s anxiety, as well as financial concerns.  Some people are apprehensive to establish care because it has been a long time since they’ve been to a dentist and they are embarrassed to have someone look in their mouth after such a long time.  We can assure you that we will never make you feel ashamed or embarrassed here at our office.  We offer only encouragement and support for anyone willing to take the initiative to begin the path towards improved dental health.

What do dentists do to relieve anxiety?
We work to reduce your anxiety before you even set foot in our dental office. This process begins when you make your appointment. Our office staff has been trained to tell you what to expect and to answer any questions you have to ensure that you will be comfortable during your visit. An understanding of your dental services and treatment can help to relieve dental anxiety. Make sure you ask questions and request informational materials, if desired.

What can I do to relieve dental anxiety?
In general, avoid caffeine before a dental appointment to make you less anxious. Eating high-protein foods also produces a calming effect, unlike sugary foods. During the procedure, focus on breathing regularly and slowly. When nervous, some people tend to hold their breath, which decreases oxygen levels and further increases feelings of anxiety.  Knowledge is the greatest defense against anxiety. If you have specific fears, talk to us about them. We can go a long way to dispel any negative or frightening images you may have.

Are there medications that can help me relax?
We can prescribe medications to help patients relax during the appointment. Talk to Dr. Licata about your concerns and ask her about the possibility of using dental sedation.  Sedation dentistry involves the use of medications to allow you to relax and feel sleepy during a dental visit or procedure.  However, sedation is not pain medication, so you may still require local anesthesia, depending upon the treatment.  There are a variety of sedation dentistry methods.  The most common types are inhaled sedation, which involves breathing in a mixture of nitrous oxide (laughing gas) and oxygen, and oral sedatives, which are medications taken by mouth.   If you decide you would like an oral sedative, a person will need to accompany you to your dental appointment to drive you.  Another type of dental sedation is intravenous (IV) sedation, which  is provided by dentists with specialized training in IV sedation.  Sedation is safe when administered by  dentists who are trained in its use. However, as with any medication, sedation involves a certain amount of risk. It is important to talk to us about these risks.  Dr. Licata does not provide IV sedation in her practice; however, she can make recommendations to other dentists in the area who do if we decided this is the best treatment option for you.

What should I do if I am a new patient and seeing Dr. Licata for the first time?
If you are a new patient and will be seeing us for the first time, you might wish to schedule an appointment for a visit—a visit that doesn’t require a cleaning or treatment.  Just come in and meet our staff and talk with us. Take the opportunity to ask us questions and address your concerns. You’ll find that a dentist who takes the time to speak with you about your anxiety will be understanding when it comes to addressing all your dental concerns.

Crowns

Crowns, also known as caps, cover a tooth to restore it to its normal shape and appearance. They are used in cases where other filling procedures will not be effective. Crowns have the longest life expectancy of all cosmetic restorations. 

A crown is a restoration that covers, or "caps," a tooth to restore it to its normal shape and size, strengthening and improving the appearance of a tooth. Crowns are necessary when a tooth is generally broken down and fillings won't solve the problem. If a tooth is cracked, a crown holds the tooth together to seal the cracks so the damage doesn't get worse. Crowns are also used to restore a tooth when there isn't enough of the tooth remaining to provide support for a large filling,  to protect weak teeth from fracturing, to restore fractured teeth or cover badly shaped or discolored teeth.
  
It takes two dental appointments to complete a crown.  To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of the teeth and gums is made and sent to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown is made. On the next visit, Dr. Licata removes the temporary crown and cements the permanent crown onto the tooth.

Why crowns and not veneers?
Crowns require more tooth structure removal, hence they cover more of the tooth than veneers. Crowns are customarily indicated for teeth that have sustained significant loss of structure or to replace missing teeth. Crowns may be placed on natural teeth or dental implants.
   
How long do crowns last?
Crowns should last approximately five to eight years. However, with good oral hygiene and dental supervision, most crowns will last for a much longer period of time. Some damaging habits like grinding your teeth, chewing ice or fingernail biting may cause this period of time to decrease significantly.
 
How should I take care of my crown?
To prevent damaging or fracturing the crown, avoid chewing hard foods, ice or other hard objects. You also want to avoid teeth grinding. Besides visiting Dr. Licata for professional cleanings and exams and brushing twice a day, flossing between your teeth is vital with crowns. Floss or interdental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in that area can cause dental decay and gum disease.

Bridges

When someone is missing a tooth, sometimes a bridge is an option to replace that missing tooth.  Usually there needs to be a healthy tooth on either side of the missing space.  Each tooth next to the missing space is shaped for a crown, and then an attached “bridge” of teeth would be cemented on each of these supports, with the artificial tooth attached in the middle.  A bridge is firmly held in place and cannot be removed, unlike a partial denture which can be taken in and out.  When a bridge is an option, often an implant could be an alternative to replacing a missing tooth.  However, some patients don’t like the idea of surgery or can’t afford the expense of an implant, and in some cases an implant isn’t an option due to the existing anatomy (if the sinus is low, or the bone is too narrow, for instance).  In the cases where implants aren’t an option, a bridge is a successful and comfortable option for a long-term tooth replacement.

It takes two dental appointments to complete a bridge.  To prepare teeth for a bridge, they are reduced so the crowns can fit over them. An impression of the teeth and gums is made and sent to the lab for the bridge fabrication. A temporary bridge is fitted over the teeth until the permanent bridge is made. On the next visit, Dr. Licata removes the temporary crowns and cements the permanent bridge onto the teeth.

If you have a missing tooth and have thought about replacing it, talk to Dr. Licata and her staff about the best replacement options for you!

Dentures and Partials

What is a denture?
A denture is a removable replacement for missing teeth and adjoining tissues. Complete dentures replace all of the teeth and are usually made of all acrylic materials.  A partial denture fills in the spaces created by missing teeth and prevents other teeth from shifting position, and often is made of a rigid metal frame with denture teeth attached to it. Complete dentures are either “conventional” or “immediate.” A conventional denture is placed in the mouth after all of the teeth have been removed and the extraction sites have healed. An immediate denture is placed as soon as the teeth are removed.

Who needs a denture?
Candidates for complete dentures have lost most or all of their teeth. A partial denture is suitable for those who have some natural teeth remaining. A denture improves chewing ability and speech, and provides support for facial muscles. A denture can greatly enhance a patient’s facial appearance and smile.

How do you get a denture?
The denture process takes about one month. There are usually four or five appointments needed to complete the process. The process includes the initial diagnosis; the making of an impression and wax bite to determine the dimensions and proper jaw position; a “try-in” to assure proper color, shape, and fit; placement of the final denture; and any minor adjustments. New denture wearers need time to get accustomed to their new “teeth,” because even the best-fitting dentures will feel awkward at first. Your normal speaking ability usually resumes shortly after final denture placement.  In addition, in order to become accustomed to chewing with the new denture, it is often recommended that you start with soft, easy-to-chew foods. To ensure proper fit, see us on a regular basis.

How do you care for a denture?
Whether you have a full or partial denture, you need to keep a regular recare schedule with us.  We will clean your denture in a special solution in an ultrasonic cleaner to help keep it at it’s best.  Other hints include:
  • Remove and brush the denture daily with a denture cleanser or toothpaste and a brush designed specifically for cleaning dentures.
  • Avoid using boiling water to sterilize the denture, because hot water can cause the denture to lose its shape.
  • If you wear a partial denture, remove it before brushing your natural teeth.
  • When you’re not wearing the denture, soak it in denture cleanser or water.
  • To avoid misplacing your denture, store it in the same place after removal.

Should a denture be worn at night?
While you may be advised to wear your denture almost continually during the first few days if you have an immediate denture placed—even while you sleep—under normal circumstances, it is considered best to remove it at night. Research has shown that removing the denture for at least eight hours during either the day or night allows the gum tissue to rest, and permits for normal stimulation and cleansing of the mouth by the tongue and saliva. This promotes better long-term health of the gums.

Are there any alternatives to dentures?
Dentures are no longer the only way to restore a mouth that has little or no teeth. Dental implants are artificial tooth roots that are surgically anchored into your jaw to hold a replacement tooth or bridge in place. Implants and bridges may more closely resemble the “feel” of real teeth, but they tend to be more expensive than dentures. Not everyone is a candidate for implants and bridges, however. Talk to us to learn more.

Sealants

In addition to good oral hygiene, including brushing and flossing, there are other ways to protect teeth from decay. Dental sealants can protect teeth and seal them off from decay-causing bacteria.

Dental sealants are made of plastic and are applied to the chewing surfaces of the back teeth to prevent decay. The plastic fits into the depressions and grooves (pits and fissures) of teeth. The sealants protect tooth enamel from the bacteria and acids that cause decay.

While brushing and flossing help to remove food particles and plaque from smooth surfaces of teeth, toothbrush bristles often can’t reach into the teeth’s depressions and grooves. Sealants protect those areas and prevent food and bacteria from getting in.

Dr. Licata and her staff can apply sealants easily, and it takes only a few minutes to seal each tooth. We first clean the teeth that will be sealed, which may require the use of a dental drill to open the grooves of the teeth and determine if decay is present. Then we roughen the chewing surfaces with an acid solution, which will help the sealant stick to the teeth. We then “paint” the sealant on the tooth. It bonds directly to the tooth and hardens using a special curing light to help it bond to the tooth.

Decay can begin early in life, so we usually apply sealants to children’s and teenagers’ premolars and molars to protect them. But sealants can protect adults’ teeth, too. Ask us about sealants for your children or for yourself to see if they would be beneficial.

As long as the sealant remains intact, the tooth surface will be protected from decay. Sealants hold up well under the force of normal chewing and usually last several years before a reapplication is needed. The risk of decay decreases significantly after sealant application. During your regular dental visits, Dr. Licata will check the condition of the sealants and reapply them when necessary.

Sealants are extremely safe, though some people may have an allergic reaction to the plastic. Talk to us if you or your children have allergies so we can provide the best treatment options.

Health insurance usually will pay for sealants in children’s and teenagers’ permanent molars. If we suggest sealants for adults, often the costs will not be covered by insurance. Be sure to check with your insurance company about your plan as coverage may vary.

Adult Comprehensive Care

Luckily, most people visit our office for the first time without any urgent problems.  People are looking to become established with a quality practice where they know they will receive excellent care and maintain great oral health.  In order to have a comprehensive understanding of your mouth, there are a number of things we do on your first visit to gather all the information we need.  Adults will be in our office about an hour and a half on the first visit to our office. 

First, we’ll start with a complete x-ray series of your mouth, consisting of about 18 different views of your teeth so we can see all the roots and supporting jaw bone around your teeth.

Next, we’ll do a periodontal charting.  This is where we take a small measuring-type tooth ruler and record your “pocket depths”—this is how deep your bone lies below the gum surface.  This gives us great insight into the health of your mouth.  We hope to find healthy pockets of 2-3 mm throughout your mouth—anything greater can indicate areas where periodontal disease may be active.

We will also do an intra-oral camera exam, where we take a small digital camera and record pictures of your teeth to show how the fillings and natural surfaces are doing.

Dr. Licata will do a comprehensive exam of your teeth and mouth, noting any areas where previous dental treatment has been done, and if there are any problems in existence.  Dr. Licata will discuss her findings with you at that appointment, and if any problems are found, she will then prepare a written proposal of the treatment you need.

If we find your mouth to be healthy, we’ll proceed on with a thorough dental cleaning at that appointment.  If we find signs of periodontal disease, we will stop at that point and inform you of our findings, and offer you different options for treatment in order to address your gum disease.  These options would entail further appointments after this initial appointment to begin gum treatment. 

Children’s Care

Children will be here about ½ hour on their first visit.  We will usually take 2 to 4 bitewing x-rays and do a precursory check of the health of the gums.  Intra-oral camera pictures are taken if a problem is seen.  Dr. Licata will do a comprehensive exam, checking how the bite is developing and looking for loose teeth and cavities.  The patient will have their teeth cleaned, polished, and flossed, and if they are under the age of 16, we will apply a protective fluoride varnish to protect against cavities. 

Teen’s Care

Teens will be here about 45 minutes to 1 hour on their first visit.  We will usually take 4 to 7 bitewing x-rays and do a precursory check of the health of the gums.  Intra-oral camera pictures are taken if a problem is seen.  Dr. Licata will do a comprehensive exam, checking how the bite is developing,looking for loose teeth and cavities, and checking for third molars.  The patient will have their teeth cleaned, polished, and flossed, and if they are under the age of 16, we will apply a protective fluoride varnish to protect against cavities. 

Referrals to Specialists

Dr. Licata does a multitude of dental treatments to keep your teeth healthy and looking their best.  There are times, however, if a patient needs certain treatment, when Dr. Licata will refer you to receive the help of a specialist.  The areas where specialist care might be needed include the specialties of  Endodontics (root canals), Oral Surgery and Periodontics (for gum surgeries, extractions, and implant placements).  Dr. Licata has carefully sought out specialists all around the area to help provide our patients with the same kind and caring treatment that our patients have come to expect from our office.  Dr. Licata works in close communication with her referring specialists to be sure everyone is clear on the goal of the treatment being performed, so that everyone is always on the “same page”.  An open dialogue of communication is the key to success for our patients to receive the most ideal treatment available!

Recare Visits

Depending on the health of your gums, most  adult recare appointments last an hour.  You will have your teeth cleaned, flossed, and polished by one of our hygienists.  If needed, the hygienist might apply some desensitizing medications, fluoride varnish, or antibiotics below the gumline.  Some patients are on a 6-month schedule, and those with periodontal disease concerns are usually on a 3 or 4-month schedule.  We will update bitewing x-rays once a year, and request a new full series x-ray every 5-6 years.  We will update the periodontal charting (where we look for signs of gum disease) every 1-2 years, depending on the patient’s health status.  Dr. Licata will do a comprehensive exam once every 6-8 months, or more often if a patient has any concerns.

New Technology

Dr. Licata utilizes the latest dental technologies in her practice each and every day. 

Our office takes digital x-rays which are more comfortable, faster, and less radiation exposure for the patient. 

We also take digital intraoral camera pictures (pictures that show your actual teeth on the computer screen) so you can see what they look like. 

We use a diagnostic laser to detect cavities in teeth.  This helps us be more conservative, but also not miss any beginning cavities.

Dr. Licata uses a plasma arc light for doing all of our chairside bleaching and bonding procedures.  This saves you time in the chair as we are able to complete our procedures must faster than using older, conventional curing lights.

Dr. Licata attends several hours of continuing education a year to learn about the newest techniques, materials, and equipment available in order to provide our patients with the most current and comfortable treatment available.