Oral Surgery - Extractions

Our practice has trained and invested in the Ogräm System of atraumatic extraction of teeth. This technique was developed by a team of professionals in the US and Europe with a goal of developing  a system that preserves the surrounding dental structures when removing teeth. This improves healing and reduces post-operative discomfort and complications in most patients.  Although this technique is a significant change from traditional extraction techniques, our office has seen a marked decrease in post- operative complications and improved patient healing since its implementation.

Habit Training

Habits that are harmful contribute to malocclusions and poor skeletal development.  The earlier these habits are addressed the better the outcome will be for the developing child.  The cause behind some of the habits is not always obvious.   Examples of this can be swallowing or breathing dysfunctions.

Diagnosis of these habits can be a difficult thing to determine without certain technologies.   We use Rhinomanometry, surface EMG with diagnostic testing software, and a dental CT (cone beam) as diagnostic tools to help us identify the habits (see Technology section).   We can then treat the harmful habits with dental appliances in conjunction with exercises and biofeedback.   This has been developed through our interaction with the Florida Dento-Facial Study Club (FDFSC) led by Dr. Carl Gugino.  We are continuing to work with other professionals around the country and from Japan in defining and refining protocols and training methods.  This is the direct result of instruction from Dr. Gugino, Dr, Robert Grove, Dr. Ivan Dus and the Bioprogressive Study Club of Japan.

Our registered dental assistant, Laurie, is the therapist educated in these protocols.  She received her training through the FDFSC and Dr. Jim Farrage of Loma Linda University Department of Orthodontics in California.

Root Canal Therapy

Root canal therapy is a treatment to preserve and extend the life of a tooth.  This therapy is needed when the pulp or nerve has abscessed or become damaged.  The treatment involves removal of the dead or dying nerve tissue from canals within the roots of the tooth.  Those canals are then filled with a material to seal the space once it has been cleansed by instrumentation and chemical irrigation.

Root canal therapy has a high success rate but there is always the future possibility of failure.  We believe that all root canals have a life span, but can extend the life of a diseased tooth indefinitely.   Teeth with completed root canals usually need to be restored with crowns to protect the compromised tooth from fracturing or breaking since they those teeth do become brittle over time.

Anti-infective Therapy

Non Surgical, Anti-Infective Periodontal Therapy

We believe that the health of the teeth and gums have a significant effect on the overall health of our bodies. A strong relationship between oral disease and other systemic diseases is substantiated by scientific literature and research. Harmful levels of oral bacteria can have serious effects on the entire body. Our goal is to establish good oral health in all of our patients. One way we accomplish this is by using a process called anti-infective therapy, the Keyes technique.

Three ways oral disease may affect a person’s overall health:

Bacteria from the gums enter the saliva and can adhere to water droplets in the air that is inhaled each time you breathe. These droplets containing bacteria can then enter the lungs and have the potential to cause infections within the lungs.

The bacteria can also enter the body by way of the lungs.

Bacteria can also enter the body’s circulatory system through the gums that surround the teeth and travel to all parts of the body. These bacteria can cause issues in the areas of the body that they may find their way to. This can cause secondary infections or contribute to other disease processes in the effected organs or systems.

The inflammation associated with gum disease may stimulate additional systemic inflammatory diseases such as pulmonary disease, fetal development, cardiovascular disease, diabetes, orthopedic implant failure, and kidney disease.

Periodontal Care

Gum or periodontal disease in most cases is the result of bacteria being allowed to colonize around the teeth and gums. These bacteria come in many different forms or types with some being more destructive than others. We believe that the treatment of gum disease should focus on the control of bacteria that inhibit the oral cavity.

The body sees teeth that are infected or colonized by bacteria as being a threat to the body. Just as the body attempts to eliminate any invading bacterial infection, it also attempts to eliminate teeth that it sees as a threat. This is the reason that the bone surrounding the teeth deteriorate. The bone that supports and holds the teeth in the mouth eventually deteriorate until the tooth becomes looser and either falls out or has to be extracted.

We believe that the best treatment for gum disease is a process called anti-infective therapy.  This process was developed by Dr. Paul Keyes (drpaulkeyes.com) and is often referred to as the Keyes technique.  Our hygienist has been trained and utilizes this philosophy to train our patients how they can eliminate their disease.  She uses a phase contrast microscope along with other modalities to train and treat our patients.

This anti-infective therapy process can in most cases be a substitute for expensive and usually painful surgery.

Fillings - Restorations

Because we believe the type of fillings known as dental amalgams are not in the best interest of our patients, we no longer use silver or mercury filling materials in our practice. We made the decision over 18 years ago to only use bonded composite restorations for fillings we place for our patients. There are several advantages for using this type of restoration over the 50% mercury fillings of the past. The composite  materials we use now provide a better seal by bonding with the tooth and actually strengthening the tooth. For patients with metal sensitivities or allergies using composites can greatly help in eliminating their concerns.

Function

Neuromuscular Dentistry

The goal in neuromuscular dentistry is to place the jaw joints into the best position possible for proper function and good health.  This is done by working with the muscles and nerves that control the function of the bones of the jaw and teeth structures.  We accomplish this by using surface electromyography (EMG) and on occasion, a low frequency TENS unit (transcutaneous electrical nerve stimulation).

Surface EMG is a worldwide standard for recording muscle function and activity.  We use it in our practice in several ways to establish the presence or absence of muscle dysfunction. We then continue to use it as we correct that dysfunction.  Knowing the quality of muscle activity is an important tool since it is used in many areas of general dentistry within our practice including orthodontics, implants, occlusion or bite correction, temporomandibular joint dysfunction (TMJ) and sleep disorders.

Our philosophy is based on training we received from Dr. Robert Grove of California, Dr. Carl Gugino of Florida, Dr. Ivan Dus of Italy and Mytronics, Inc. of Seattle, Washington.

TMJ

Philosophy

Our practice has been treating patients with jaw joint dysfunction, known commonly as TMJ problems, and other associated muscular problems for over 20 years.   Our approach to this problem has been developed over the years from continued training.  We received training from several leading dental professionals throughout the country such as Dr. Eugene Williamson at the Foundation for Advance Research and Training in Augusta, Georgia.   We approach this dysfunction from a neuromuscular perspective of treatment.  (see Neuromuscular Dentistry section)

Diagnosis & Treatment Planning

Diagnosis

We have several state of the art technologies in our office we use to work with the muscles and nerves that control function to treat the dysfunction causing the problem.   Our cone beam technology, dental CT, allows us to capture 3-D images of the jaw joint that aid us in the diagnosis of TMJ pathology.  We also use our surface EMG (see EMG section in Services) to record muscle function and activity.   A review of the patient’s diagnostic records is then completed so that an individualized treatment plan can be developed based on those findings and the needs of each patient’s unique situation.

Treatment

Treatment for the TMJ patient is complex and must be individually tailored once the diagnosis is determined from the patient’s unique issues, their oral and medical situation and even their lifestyle.  Most therapy usually involves fabricating a dental orthotic (acrylic mouthpiece) for the patient to wear regularly.  We can then use the orthotic to reposition the jaw into a neutral neuromuscular position.  The orthotic is checked regularly during the treatment period and adjusted as the muscles and joints readjust to this neutral position.

The goal of our therapy is to initiate healing in the TMJ and establish a means of maintaining stability for the jaw, muscles, and teeth (bite).  This is accomplished by artificially changing the occlusion (bite) and jaw position.  We may also need to introduce additional therapies, including habit training, to correct negative issues (see Habit Training section).  Therapy for this problem takes approximately 6 months of working with and monitoring the patient’s progress to obtain stable results.

Once the joint and muscles become stable, treatment options for a more permanent solution to stabilize the joints are discussed with the patient.  The goal is to help the patient manage their condition including better function.

Crown & Bridge Restorations

We are fortunate to have the benefit of a high quality local dental laboratory that we utilize to fabricate our crowns and bridges.  Because our laboratory is local, we are able to work more closely with the lab to create a customized esthetic restoration.  We choose to use high noble gold alloys in our metal and/or metal with porcelain crowns and bridges as well as our implant-supported restorations.  We also use Zirconia and porcelain when the situation calls for a non-metal restoration.

Denture Prosthesis

Conventional Denture Prosthesis

We are fortunate to have our own in-house laboratory where we construct our conventional full and removable partial dentures.  This allows us to create a superior prosthesis tailored to the patient’s requests and needs both in function and esthetics.

Dr. Foust was blessed to have worked alongside Knoxville’s first master certified dental technician (CDT), Mr. Ed Cutshaw.   Ed’s presence in our office laboratory for many years along with his certification in all phases of prosthetic dentistry gifted Dr. Foust with a unique opportunity.  This opportunity allowed him to learn from Ed’s expertise and wisdom of over 50 years in dental prosthetic design and customization creating beautiful smiles with full and partial dentures.    Since Ed retired we have maintained our in-house laboratory by utilizing the talents and expertise of one our dental assistants, Karin.  Her past experience in dental laboratories has made her the perfect fit for our continuing laboratory needs.  (See Karin’s Bio  in “About Us” section)

Screw-Retained Dentures (Hybrid Dentures)

Dentures that can be secured to dental implants allow them to function like natural teeth.  This is a process whereby esthetics and function can be reproduced for our patients creating a more stable prosthesis.  We have seen many denture patients complain with loose or poorly functioning dentures due to the continuation of bone loss over the life of their dentures.  In most cases this complaint cannot be remedied by merely making a “new set”.  For those patients the option of implants and a new hybrid denture allows them to eat and function as with their own natural teeth.

The laboratory we utilize for fabrication of our customized screw-retained dentures is locally owned and operated here in Knoxville.  Their proximity to us allows for a working partnership to personalize each denture both during the treatment planning phase and continuing throughout the actual treatment steps needed for completion of the dentures.