Dental Services in San Diego
When teeth are missing a series of changes that can impact your overall dental health and jaw function may be initiated. The adjacent teeth may start to drift or tilt into space, and teeth in the opposing jaw may start to shift toward the area of the missing tooth. It is therefore essential to replace the single tooth or multiple teeth that have been lost. One of the best options to prevent the consequences of shifting teeth and to restore full function to a small edentulous section in the mouth is a dental bridge.
A dental bridge replaces the missing teeth with artificial teeth called “pontics,” and is supported on the ends by prepared natural teeth. Once fabricated and fitted a dental bridge will be permanently “fixed,” or cemented into place. Like crowns, bridges can be made of either porcelain baked on to a metal substrate or many of the new ceramic materials that have been developed.
Crowns & Caps
The terms dental crowns and caps are synonymous. If dental decay, cracked fillings, root canals, clenching or grinding the teeth have caused extensive damage to the underlying tooth structure a dental filling may not be a sufficient restoration. The only way to completely restore the cosmetic appearance and function of this tooth is often full coverage with a dental crown. The good news is that a completed dental crown looks and feels like a natural tooth.
In addition to restoring a single natural tooth, crowns can be used in other situations including being the supporting ends of dental bridge, covering dental implants, or as coverage for a cracked tooth to prevent further breakdown. A crown may also be indicated when a discolored or stained tooth needs to be restored to its natural appearance. Crowns can be made of either porcelain baked onto a metal substrate, all-porcelain, or many of the new ceramic materials that have been developed.
Dental Fillings are the most common type of dental restoration used to replace sections of teeth that are missing, damaged or decayed. While traditional dental materials like gold, amalgam, porcelain, and composite successfully restore teeth; recent advances in dental technology have made a wider and improved selection of restorative choices available. Some of the newest state-of-the-art filling materials including ceramic and the latest composite materials, are not only strong and durable, they offer the most aesthetically pleasing and natural looking results.
Dental emergencies can come about in any number of ways. Your discomfort may be due to an injury to the oral facial area, the acute flare up of a longstanding problem, or the result of the sudden onset of seemingly inexplicable pain. Whatever the case may be, urgent dental care is needed to provide you with relief and to avoid any further consequences to your oral health or function, as well as your overall well being.
There are many reasons to seek emergency dental care, including severe toothaches, chipped or fractured teeth, a dental abscess, impacted teeth, loose or broken fillings, lost or dislodged crowns, broken dentures and more. While the pain of a toothache is one of the more common reasons that patients come to our dental office for emergency dental care, we also promptly treat emergencies that are not necessarily painful like crowns that have been dislodged and broken dentures that leave embarrassing gaps in one’s smile.
Whether your dental emergency is painful, if it affects the appearance of your smile, or if you suspect that an infection is present, contact our office immediately for care. We will make every effort to see you as promptly as possible.
Initial Oral Examination
Your first visit to our office is very important with regard to establishing your oral health baseline. We will begin by carefully reviewing your medical and dental histories and taking special note of all of your dental concerns, as well as any symptoms that you may be experiencing. This will be followed by a thorough clinical examination, including an oral cancer screening, periodontal evaluation, an analysis of your occlusion (bite) plus a thorough examination of your teeth, their supporting structures, and the complete orofacial area. Any needed diagnostic dental films will be taken at this time.
Invisalign® is a form of orthodontic treatment that works to correct many different types of malocclusions through the use of a series of clear plastic trays called aligners. In many cases it provides an excellent treatment alternative to having traditional orthodontic braces and metal wires.
Invisalign utilizes 3-D computer imaging technology to correct problematic bites or malocclusions by planning a complete sequence of custom-made clear aligners. This series of clear aligners, each of which is worn for a couple of weeks, incrementally move the teeth into place until the final desired corrections are reached.
The advantage and appeal of invisalign appliances is that they are more cosmetic and more comfortable than most other orthodontic appliances. With Invisalign appliances orthodontic treatment is practically “invisible.”
Chronic jaw clenching and grinding one’s teeth is called bruxism. While it can happen any time of day, it often occurs at night causing an individual to wake up with any number of symptoms including jaw pain, headaches, and sore teeth that may feel loose. Although, stress and anxiety are the most common causes of bruxism there may be other contributing factors such as a sleep disorder, an abnormal bite, as well as teeth that are missing or poorly aligned.
To alleviate the symptoms of bruxism, wearing a night guard while sleeping is frequently recommended. This appliance is designed to fit over the teeth and to keep the jaws slightly apart. Wearing a night guard prevents a number of damaging events including muscle strain, excessive pressure on the jaw joint (the TMJ), and such dental damage as chipped or cracked teeth resulting from the teeth grinding against each other.
In addition to preventing damage to the soft and hard tissues surrounding the orofacial cavity, a custom night guard fabricated at the dental office can help curb a bruxism habit and give the wearer a better night’s sleep.
A healthy, functional and attractive smile requires teeth that are straight and jaws that are well aligned. The goal of orthodontic treatment is to correct the cosmetic and functional problems associated with teeth that are either overcrowded, have spaces between them, or that have shifted over time due to extractions, habits, or abnormal bite patterns. Orthodontics can also address skeletal discrepancies between the upper and lower jaws.
Orthodontic treatment can range from the minor movement of a few teeth to the alignment of an entire bite. It may also be used in some cases to align teeth both before and after the surgical correction of severe jaw discrepancies.
Orthodontics utilizes the principles of physics to slowly move teeth into their proper positions. This is performed by using a selection of corrective appliances, including braces, clear aligners, and retainers. Designed to apply incremental and controlled forces to move the teeth in the desired direction, these appliances are adjusted on a regular basis throughout the course of care. Once a malocclusion is corrected and the teeth are completely aligned, retainers are often placed to help ensure that the result remains stable.
Orthodontic treatment time depends on the patient’s age, the severity of the malocclusion and the unique needs of each particular case. Some corrections can be accomplished in a few months while others can take a few years. However, for many malocclusions the average length of orthodontic treatment time is 24 months.
Pediatric Dental Care
At our office we take pride in creating and maintaining beautiful and healthy smiles for our younger patients in an environment that is lighthearted and fun. With an emphasis on establishing oral health habits that last a lifetime, our primary tools are education and a comprehensive preventive care program.
As part of an effort to guard against childhood dental decay we recommend periodic fluoride treatments and dental sealants placed on the biting surfaces of the back teeth.
Orthodontics for Children
Most problems involving the alignment of your child’s teeth and the growth of their jaws can be identified by the time they are in the first or second grade. That is why the American Association of Orthodontists recommends that all children have a check-up with an orthodontic specialist no later than age 7. At this visit, the orthodontist will carefully examine your child’s bite and assess the alignment and development of the teeth. The orthodontist will also look at the growth and relationships of the jaws, and in particular check for any shifts or dysfunction. It will also be determined if any premature tooth loss, habits, swallowing or breathing patterns are having an effect on your child’s occlusion.
Following this visit the orthodontist will indicate if any immediate preventative or interceptive orthodontic care is needed. In many circumstances, no treatment is required right away and the child can be observed until it is the appropriate time for care. Your child’s dental development, as well as their prospective facial growth, will be carefully considered in outlining the best timetable for care.
Orthodontic treatment for children typically begins between the ages of 9 and 14. At this time they are generally in the mid to late mixed dentition stage. This means they have a mix of permanent front teeth, permanent molars, and some baby teeth. The benefit of placing braces at this stage is that the orthodontist can improve the alignment of permanent front teeth, guide the incoming new adult teeth into position, and utilize the child’s growth and development to best advantage.
Often habits such as prolonged thumb sucking, tongue thrusting, and certain swallowing or breathing patterns that can open or distort the bite are better dealt with when care is initiated at a younger age. Early treatment is also helpful when the top jaw is too narrow, not developing in harmony with the lower jaw, or if permanent top teeth are behind the lower ones when closing the jaws. Likewise, if a young child’s front teeth protrude excessively or very severe crowding is present the first phase of orthodontic care can be beneficial.
The objectives of early treatment and the first phase of orthodontic care are to influence jaw growth, create more space for crowded teeth, help to correct harmful habits, and improve facial aesthetics. With early treatment, the likelihood of impacted permanent teeth as well as the need for extractions of permanent teeth can be lessened. Early treatment can also simplify the next phase of orthodontic care.
Periodontal disease damages the surrounding soft tissues and bone that support the teeth. It is predominantly caused by the accumulation of bacteria, mucus and other particles in the form of plaque or tartar that sit between the teeth and the gums. Periodontal disease can range in severity from a simple gum inflammation, known as gingivitis, to a more serious inflammation of the periodontal tissues. Left untreated periodontal disease can result in significant tissue damage and eventual tooth loss.
The problem with periodontal disease is that often the progression is painless. As a result the affected individual may not be aware of an ongoing disease process. This is why it is so important to recognize the signs of the earliest stage of periodontal disease, which is gingivitis. The symptoms of gingivitis typically include red, swollen and bleeding gums. Treatment instituted at this point is often sufficient to reverse the course of the disease and to avoid any permanent damage to the periodontal tissues. A series of deep dental cleanings, an improved home care regimen, and a commitment to regular maintenance may be all that is required to prevent this stage of periodontal disease from progressing.
Left untreated, gingivitis can escalate into periodontitis. However, there are other factors that can contribute to the escalation of periodontal disease, including smoking, genetic tendencies, and unchecked diabetes. In either case, when periodontal disease has progressed to a more advanced stage there is usually clinical and radiographic evidence of damage to the bone and soft tissues supporting the teeth. Periodontal treatment in this phase is designed to halt the progression of the disease and to restore tooth support as possible. This may involve medications to control the bacteria and reduce the size of the pockets between the teeth and gums, gum surgery, as well as bone and tissue grafts.
Sleep apnea is a serious and potentially life threatening disorder involving repeated pauses in breathing while asleep. The most common form of this condition is obstructive sleep apnea. This occurs when there is an obstruction of an individual’s airway that interferes with the flow of oxygen through the nose or mouth during sleep. In someone afflicted with obstructive sleep apnea, the muscles of the throat and mouth relax during sleep to the point where they fall back into the upper airway and create a blockage that restricts breathing.
The signs and symptoms of this disorder during sleeping hours may include, loud snoring, episodes of breathing cessation, abrupt awakenings, episodes of gasping for air, along with difficulties getting a good night’s sleep. An individual with sleep apnea will exhibit problems during the day as well. Sleep apnea can lead to a morning headache, excessive daytime sleepiness, difficulty concentrating, and irritability.
A sleep study is typically conducted to determine the severity of the disorder. The results of this study along with other medical findings will play a role in determining the recommended therapy. The most common form of therapy is a CPAP machine that is worn when sleeping. This device provides a steady stream of pressurized air into the respiratory system through a mask.
In situations of mild to moderate sleep apnea, a dental appliance may be deemed the appropriate treatment. Worn in a similar fashion to a mouthguard or an orthodontic retainer, it is designed to help keep the tongue and soft tissues in the back of the throat from collapsing, thereby enabling the airway to stay open during sleep. An oral appliance is easy to wear, easy to care for, comfortable, and portable. Oral appliances are individually fabricated, and customized for both maximum effectiveness and comfort.
Getting a full night of sleep is essential to your overall health. Being well rested helps you to feel good and to function at your best. One of the most common problems that can affect the quality of your sleep is snoring. According to statistics about 90 million individuals in the United States snore while they sleep. While for about half of these people the problem is simply snoring, the others may be afflicted with a serious disorder known as sleep apnea. Therefore, before any type of treatment can be prescribed, it must be determined whether the problem is sleep apnea or “simple” snoring.
If it is determined that your problem is simply snoring, and you are what is known as a primary snorer, then an oral appliance can help you as well as any of your roommates enjoy a quieter and more comfortable sleep. A custom fabricated oral appliance to address snoring fits somewhat like a sports mouthguard or orthodontic retainer and is only worn while you sleep. As a removable and non-invasive treatment for snoring, your appliance slightly repositions your jaw to allow for a less restricted airflow to promote a quieter and more restful sleep.
Every year millions of cases of dental and facial injuries occur as the result of sport-related trauma. While all sports have some risk of oral injury, it is especially prevalent in recreational activities that involve frequent body contact with other players or the ground, as well as the possibility of being struck by other objects such as, balls, bats, or sticks.
One way to significantly reduce the risk of damage to your teeth, cheeks, lips, tongue, face, or jaw as the result of a sports-related injury is to wear a mouthguard. A mouthguard is a removable appliance made of a sturdy plastic that sits comfortably over your teeth. Typically, mouthguards are designed to cover just the top teeth but may also be fabricated to include the lower teeth as well depending on your particular situation. Individuals who wear braces or have some types of dental work may require a specific type of mouthguard that provides more coverage.
There are three types of sports mouthguards on the market, including pre-formed and ready to wear stock mouthguards, boil and bite mouthguards, and custom mouthguards fabricated by your dentist. Our office will help you to select just the right sports mouthguard to protect your smile. While the first two choices offer some level of protection, the best and most comfortable mouthguards to safeguard your smile are the ones individually designed and customized by your dentist.
Teeth that have been stained or darkened by food, tobacco use, age, medications or injury can be lightened and brightened by means of a non-invasive process known as teeth whitening.
Teeth whitening or bleaching simply refers to any process that will make the teeth appear whiter. While there are many over the counter options for teeth whitening, the most effective and safest teeth whitening systems are the professional strength ones available at the dentist’s office. A dental professional whitening system offers a higher concentration of whitening components and delivers them to the teeth in the most efficient manner to achieve optimal results.
At our office we offer two exceptional options for tooth whitening. You can choose either an in-office tooth whitening procedure or a professional take home system. Both of these are top-of the-line systems. However, the biggest advantage of the in-office procedure is that in as little as one hour you can achieve a smile that is several shades whiter and brighter than the original color of your teeth.
Our professional strength take home system also produces excellent results. However, this is achieved by way of a more gradual process. Our take home kit may be prescribed alone, or after an in-office treatment to perfect or maintain the in-office result.
The Preventative Program
According to recent studies good oral hygiene is essential not only for your dental health, it is important to your overall health and well-being. Our comprehensive dental hygiene program is designed to preserve your teeth and the supporting structures by preventing the onset, progress, and recurrence of dental disease.
To maintain your optimal oral health we recommend periodic professional dental cleanings. Removing plaque and debris from teeth, especially from places where a toothbrush can’t reach, like underneath the gum line and in-between teeth is extremely important.
It is also important to keep in mind that in conjunction with periodic dental professional cleanings, a good dental home care regimen is necessary. As part of the preventive program at this office your current home care practices will be reviewed. Following that, we will make recommendations as to what areas require improvements, and instruct you in the proper methods of brushing and flossing.
Additional preventive services may be indicated for individual patients. An integral part of our preventive program for pediatric patients includes periodic fluoride treatments and the application of dental sealants.
The Prevalence of Temporomandibular Joint Problems
According to the National Institute of Dental and Craniofacial Research (NIDCR), temporomandibular joint disorders (TMJ), also referred to as temporomandibular disorders (TMD), are the most common source of chronic facial pain and jaw dysfunction. It is estimated that more than 10 million people in the United States are affected by temporomandibular joint problems.
What is the Temporomandibular Joint?
There are two temporomandibular joints that connect the left and right sides of the lower jaw to the temporal bone. Both joints and their associated muscles, ligaments and tendons work together to allow for all manner of oral function as the jaw moves up and down, front to back and from side to side. Containing a shock-absorbing, soft disc that sits between the rounded condyles of both sides of the lower jaw and the corresponding concavities in the skull’s temporal bone, the TMJ makes chewing, speaking, yawning and all jaw movements possible.
Since the TMJ is a joint with both up and down hinge-like movements, as well as side to side and front to back sliding motions to perform, it is often considered one of the most complicated joints in the body and one of the most difficult to treat when problems arise.
Types and Symptoms of TMJ Disorders
TMJ disorders can fall into one or more of the following three categories:
- Myofascial pain- Refers to pain in the area of the jaw joint due to various causes of increased muscle tension and spasm
- Internal derangement-Involves displacement of the disc, jaw dislocation or trauma to the condyles of the jaw
- Degenerative joint disease -Arthritis
The risk for developing a TMJ problem is greater in the presence of long-term teeth grinding or bruxism, a jaw injury or various types of arthritis such as rheumatoid arthritis and osteoarthritis. Furthermore, the manifestations of a TMJ disorder can vary from person to person with a wide range of symptoms possible, including earaches, ringing in the ears (tinnitus), headaches, back and neck pain, vertigo, muscle spasms and joint tenderness as well as jaw pain, popping or grating sounds with jaw movement, jaw locking and limited jaw movement. For some people a TMJ disorder can be resolved within a relatively short period of time, while for others it will continue to persist despite extensive therapy.
Diagnosis and Treatment
When evaluating for the presence of a TMJ disorder, the dentist will perform a thorough clinical assessment of joint symptoms and function. Special radiographic imaging and other diagnostic tests will be ordered as needed. The treatment of a TMJ disorder may include oral appliances such as night guards or stabilization splints to alleviate strain on the joints. Other types of therapy may include steroid injections, occlusal adjustments as well as orthodontic or prosthodontic treatment to improve occlusion. In cases of persistent and serious TMJ problems, surgery may be recommended.
Methods of self-care can be helpful in alleviating some of the symptoms of a TMJ disorder. Patients are typically advised to eat soft foods, avoid extreme jaw movement such as wide yawning and gum chewing, to practice stress reduction and relaxation techniques and applying ice packs or moist heat as directed. If recommended, a patient should follow the dentist or therapist’s instruction for gentle stretching exercises. The short-term use of over-the-counter, non-steroidal, anti-inflammatory drugs and pain medications may provide relief. If not the dentist or physician may prescribe stronger pain or anti-inflammatory drugs, muscle relaxants or anti-depressants.
VELscope Cancer Screening
The VELscope is an advanced oral assessment technology system that offers clinicians the ability to visualize oral tissue abnormalities that may indicate the presence of oral cancer or pre-malignant dysplasia. A VELscope evaluation is quick, painless, and can be easily incorporated into an oral cancer screening visit.
The VELscope is a handheld scope that utilizes an imaging modality that is sensitive to changes in the natural tissue fluorescence of the oral mucosa. The bright blue light of the VELscope can distinguish healthy soft tissue inside the mouth from soft tissue that has undergone pathological changes.
This ability to identify, evaluate and monitor abnormal soft tissue changes that might not be caught otherwise makes the VELscope an excellent addition to a periodic head and neck exam.
If your teeth suffer from gaps, chips, stains, or discolorations you may be a candidate for porcelain veneers, a highly effective and minimally invasive cosmetic procedure that can achieve beautiful results.
Porcelain veneers are thin facings custom-made of the highest quality ceramic materials that are designed to fit perfectly over the front of your teeth. One of the most conservative cosmetic treatments available, veneers can mask a host of dental imperfections to give you the smile that you have always wanted. Porcelain veneers not only enhance and improve the shape of your teeth, they are able to create an overall whiter and brighter smile.
One of the most appealing aspects of the process of fabricating porcelain veneers is that they involve minimal tooth preparation and take just a few visits. Porcelain veneers, once they are fabricated and fitted, are permanently bonded to the underlying teeth. The result is a naturally pleasing smile that is both strong and durable.
"I've always been happy with their service, and I don't have much dental anxiety. If you do, be sure to let them know, so they can get out the kid gloves."
"Dr. Murillo has been my dentist for approximately 5 years and I have to say this has been the best experience! All the staff are super friendly, personable, and treat you like your family. Dr. Murillo is very knowledgeable, personable, and goes above and beyond to make you well informed and provide any necessary care. I have peace of mind knowing I'm getting the best care when I go here."
"I have been going to this business for 44 years. Dr. Murillo has only been the owner for the last 8 years, but she is gentle, considerate and compassionate as a dentist. If you are a chicken about dentists....she is your best bet."
"I have been going to this dental practice for decades prior to Dr. Murillo taking over. The staff is amazing, notably Kelly at the front desk and hygienist of the millennium Carol. Since Dr. Murillo has taken over she has introduced ..."
"Amazing staff; friendly; best numbing shots I have ever had probably because she numbs the gums first with lidocaine gel of some kind? Have questions or want information about procedures or insurance the staff will tell you right away or find out for you. I have had excellent referrals out to other specialists and those specialists are impressed by D.D.S Maricela murrilo’s work as well."