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Why Professional Cleanings are Important

May 27th, 2020

Regular dental cleanings and checkups at our Carlsbad, Mission Viejo, or Laguna Hills office are an excellent way to ensure everything is A-OK in your mouth. There’s a reason the American Dental Association recommends a professional cleaning every six months!

Here’s what you can usually expect during your visit with Dr. Lapsi:

  • Head and neck examination: The dentist or dental hygienist will look for anything out of the ordinary. He or she will check your lymph nodes and lower jaw joints (also known as TMJs).
  • Dental examination: The dentist or hygienist will check for any signs of gum disease, tooth decay, loose or broken teeth, or damaged fillings. We’ll also check your bite, the contact between your upper and lower teeth, and the condition of any dental appliances you’re wearing. Sometimes we’ll also take a set of X-rays.
  • Dental cleaning: Plaque and tartar will be removed and the dentist or hygienist will polish your teeth. Your teeth and gums will be flossed, and we’ll also make recommendations about proper brushing and flossing technique if we think you need them.

When you visit our Carlsbad, Mission Viejo, or Laguna Hills office regularly, we’ll be able to compare the status of your teeth and gums from one appointment to another. That ensures we will be able to tell where you’re doing great in taking care of your teeth, and if needed, where you’re doing not so well.

If you’re in need of serious help, we might recommend more frequent visits. But remember, the most important factor in your oral health is how you take care of your teeth and gums at home between appointments.

We strive to help our patients achieve and maintain radiant, healthy smiles! If you'd like to know more about exams and cleanings at our Carlsbad, Mission Viejo, or Laguna Hills office, or what you need to do at home to maintain an effective oral health routine, please let us know.

Radiation and the Safety of Dental X-Rays

May 20th, 2020

It is not uncommon to be concerned about your safety when you have dental X-rays performed. Putting on a heavy lead vest may make you apprehensive. The benefits of dental X-rays far outweigh the risks when safety procedures are followed and the number of X-rays is limited to the required number.

About Dental X-rays

Intraoral X-rays are the most common, and include bitewing X-rays. These allow Dr. Lapsi and our team at Excel Dental and Orthodontics to detect caries (cavities) and check the health of your bone and root structure. Extraoral X-rays provide the information we need to monitor your jaw and temporomandibular joint (TMJ), as well as look for impacted teeth and tooth development.

X-ray Safety

A set of four bitewing X-rays exposes you to about 0.005 mSv (millisievert) of radiation, which is equal to the amount of radiation you receive in an average day from natural sources. A panoramic X-ray exposes you to about twice the amount of a bitewing. In both cases the risk is negligible and worth the diagnostic benefits.

Guidelines from the American Dental Association are offered for individuals who are not at high risk for cavities. Children in this group should have X-rays every one or two years. Teenagers should have X-rays every one-and-a-half to three years. Adults can go two to three years between X-rays. If you are at higher risk, yearly X-rays are not harmful and can save your teeth.

No matter what type of X-ray you are having, it is extremely important to tell Dr. Lapsi or one of our technicians if you are pregnant or may be pregnant. If you are concerned about the number of X-rays you are having done, or about any radiation you are exposed to, please give us a call at our convenient Carlsbad, Mission Viejo, or Laguna Hills office and talk to us about your concerns.

When Does an Underbite Need Surgery?

May 13th, 2020

When does an underbite need surgery? The short answer is: when Dr. Lapsi and our team recommend surgery as the best way to give you a healthy, functional bite. But let’s take a longer look, and see just why your doctors might come to that conclusion.

  • First, what exactly is an underbite?

In a perfect bite, the upper and lower jaws align, well, perfectly. Upper teeth overlap lower teeth very slightly, upper and lower teeth meet comfortably, and jawbones and joints function smoothly. When the alignment is off, it causes a malocclusion, or “bad bite.”

When we talk about an underbite, or Class 3 malocclusion, it means that the lower jaw protrudes further than the upper jaw. This protrusion causes the bottom teeth and jaw to overlap the upper teeth and jaw.

  • What causes an underbite?

Sometimes an underbite is caused by childhood behaviors while the teeth and jaw are developing, including tongue thrusting or prolonged thumb-sucking and pacifier use. (Working to stop these behaviors before they affect tooth and jaw formation is one of the many good reasons children should have regular visits with their dentists and pediatricians.)

Most underbites are genetic, however, and tend to run in families. It’s estimated that from five to ten percent of the population has some form of underbite. The lower jawbone (mandible) might be overdeveloped, the upper jawbone (maxilla) might be underdeveloped, both bones could be affected, or, sometimes, tooth size and placement might cause an underbite. These irregularities in jaw shape and size and/or tooth crowding are not something that can be prevented, and require professional treatment.

  • Why? What’s the problem with an underbite?

Even a minor underbite can cause difficulties with biting and chewing. A more severe underbite can lead to speech problems, decay and loss of enamel where the teeth overlap, mouth breathing and sleep apnea, persistent jaw and temporomandibular joint pain, and self-confidence issues.

  • Can’t my dentist treat my underbite?

Most probably not. A very mild underbite can be camouflaged cosmetically with veneers, but this does not address the cause of the underbite, and will not work for moderate or severe underbites.

  • Can my orthodontist treat my underbite?

Dr. Lapsi will create an underbite treatment plan after a detailed study of each patient’s individual dental and skeletal structure. Treatment options will vary depending on the cause of the underbite, its severity, and even the patient’s age.

Early intervention is especially important for children who show signs of an underbite. That’s why we recommend that children visit our Carlsbad, Mission Viejo, or Laguna Hills office by the age of seven.

If an underbite is caused by tooth misalignment or crowding, braces can reposition the lower teeth. Sometimes extractions are necessary to make room for proper alignment.

If the cause is due to jaw structure, children’s bones are still forming, so treatment can actually help correct bone development. Palatal expanders, headgear, and other appliances are various methods of encouraging and guiding bone development.

But braces and appliances aren’t effective for every patient with an underbite, and especially in patients (usually those in their late teens and older) when the jawbones are already fully formed. In this case, we might suggest coordinating treatment with an oral and maxillofacial surgeon.

  • What does an oral and maxillofacial surgeon do?

An oral surgeon has the training, experience, and skill to help correct an underbite by surgically reshaping and repositioning the jawbone. This corrective jaw surgery is called orthognathic surgery.

  • What will happen during orthognathic surgery?

Your treatment will be tailored to your specific needs. Two of the common surgical procedures for treating an underbite involve repositioning the upper jaw to lengthen it and/or reshaping the lower jaw to shorten it.

Bone is sometimes removed or added, small bone plates or screws are sometimes used to stabilize the bone after surgery—your surgeon will let you know exactly which procedures will give you a healthy, functional bite. The surgery itself is most often performed under general anesthesia and requires a brief stay in the hospital.

  • How will my orthodontist and oral surgeon coordinate my treatment?

Correcting a Class 3 malocclusion can take time. Your oral surgeon will work together with Dr. Lapsi to analyze the interrelationship of teeth, bones, and joints to determine dental and skeletal problems, and will develop the best treatment plan possible to create a healthy alignment.

  • So, when does an underbite need surgery?

Sometimes, a minor underbite can be corrected with braces and appliances alone. A serious underbite, however, will often require the specialized skills of both Dr. Lapsi and an oral surgeon.

And, while it’s not the primary purpose of surgery, corrective jaw surgery and orthodontics can also make you happier with your appearance and boost your self-confidence. Achieving a lifetime of beautiful, comfortable, and healthy smiles—that’s the answer to your question.

Why should I have my child’s wisdom teeth removed?

April 29th, 2020

The wisdom teeth are the last of the permanent molars to emerge from the gums. This can occur as early as age 17 or as late as 21. Though some teens and young adults experience a completely normal tooth eruption with ideally aligned molars that pose no health threat, this is not the case for everyone.

According to the American Association of Oral and Maxillofacial Surgeons (AAOMS), wisdom teeth must meet specific criteria to avoid a required extraction. These guidelines include:

  • Completely erupted and non-impacted
  • Completely functional
  • Painless
  • Free of decay
  • Disease-free
  • Capable of being properly cleaned

If one or more of your child’s wisdom teeth do not meet these conditions, we recommend scheduling an appointment with Dr. Lapsi; an extraction may be necessary.

Impacted wisdom teeth

One of the most common reasons for extracting a wisdom tooth is due to impaction. An impacted wisdom tooth is one that has not erupted and will not fully erupt from the gums. Usually this occurs because there is not enough room for the tooth to emerge. Impaction can be painful and can also lead to infection if left untreated. According to the AAOMS, roughly 90 percent of the teen and adult population has at least one impacted tooth. Extracting an impacted wisdom tooth early can help prevent future complications, such as periodontal disease, infections, and damage to neighboring teeth.

Extracting fully erupted wisdom teeth

Even if your child’s wisdom teeth are fully erupted, Dr. Lapsi and our team at Excel Dental and Orthodontics may recommend removing them as a preventive measure. Fully-erupted third molars often interfere with a healthy bite. This can lead to problems with tooth and jaw alignment and may also contribute to the development of headaches. Your child’s wisdom teeth may also be more prone to tooth decay and gum disease, because their location in the back of the mouth makes them more difficult to reach for brushing and flossing.

To learn more about wisdom teeth, or to schedule an appointment with Dr. Lapsi, please give us a call at our convenient Carlsbad, Mission Viejo, or Laguna Hills office!

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