Comprehensive Care

Our doctors are trained to be head and neck physicians and not simply mechanics of your teeth. We understand the link between your oral health and your systemic health and do everything in our power to promote wellness and longevity. We believe in treating the whole person and do not look at you as simply another mouth. 
We possess skills in multiple phases of dentistry. With this experience and education, we can help you with gum problems, jaw problems, tooth problems, cosmetic problems, and pain in your head and neck. Our approach to solving problems in a comprehensive fashion results in shorter treatment times, better treatment outcomes, and usually lower cost. We have found that when problems are avoided or patched, the total cost of treatment is often much greater than simply dealing with the problem initially. 

If you have any concerns or questions, please contact us to set up a consultation today.
Sometimes the effects of periodontal disease create permanent changes in the tooth and gum structure that will cause issues in the future. Enlarged gum pockets between the tooth and the gum line are common after having advanced gum disease. Sometimes these gaps are cosmetic in nature, and affect the appearance of the gums. More commonly, the gaps put the teeth at future risk for tooth and gum disease, as they are just one more place that plaque and bacteria can collect. Pocket reduction surgery is designed to thwart the after effects of periodontal disease and restore your mouth to a healthy state.

The goal of periodontal surgery is to gain access to the tooth root and to clean the damaged areas to restore to optimal function. Once the dentist can visually see the damage, it can be removed completely. Removing the plaque and decayed gum tissue leaves a pocket between the gum and the tooth. Sometimes the gum returns to its original position, but still the pocket is present. The pocket requires more frequent cleanings as the patient is unable to get to the pockets with regular brushing and flossing. Dr. Krempa will help to determine the frequency of cleanings after you've had surgery.
Exposed tooth roots are the result of gum recession. Gum graft surgery will repair the defect and help to prevent additional recession and bone loss.
Gum grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. During gum graft surgery, gum tissue from your palate or another donor source to cover the exposed root. is harvested and placed over the roots to reduce sensitivity and correct any defect. What are the benefits or gum graft surgery? A gum graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve esthetics of your smile. Whether you have a gum graft to improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence.
Procedures that regenerate lost bone and tissue supporting your teeth can reverse some of the damage caused by periodontal disease.

A regenerative procedure may be recommended when the bone supporting your teeth has been destroyed due to periodontal disease. These procedures can reverse some of the damage by regenerating lost bone and tissue. During this procedure, the gum tissue is folded back and the disease-causing bacteria is removed. Membranes (filters), bone grafts or tissue-stimulating proteins can be used to encourage your body's natural ability to regenerate bone and tissue. Eliminating existing bacteria and regenerating bone and tissue helps to reduce pocket depth and repair damage caused by the progression of periodontal disease. With a combination of daily oral hygiene and professional maintenance care, you'll increase the chances of keeping your natural teeth – and decrease the chances of other health problems associated with periodontal disease.
TMJ is the joint that connects the lower and upper jaw. The term TMJ stands for Temporo-mandibular Joint. This is one of the most complex joints in the entire body, capable of forward and backward movement, rotations, and side-to-side movements. TMJ often refers to complications and problems with this joint.

Some of the most common symptoms of TMJ problems are:
  • Pain
  • Limited movement of the lower jaw
  • Clicking sounds
  • Muscle spasms
  • Locking of the jaw

Some potential causes of the disease include genetics, hormones, low-level infections, auto-immune diseases, trauma, and clenching or grinding of the teeth.

You may need to see more than one medical specialist for your TMJ pain and symptoms. This may include a primary care provider, a dentist, or an ear, nose, and throat (ENT) doctor, depending on your symptoms.

A thorough examination may involve:
  • A dental examination to show if you have poor bite alignment
  • Feeling the joint and muscles for tenderness
  • Pressing around the head to locate areas that are sensitive or painful
  • Sliding the teeth from side to side
  • Watching, feeling, and listening to the jaw open and shut
  • X-rays or MRI of the jaw

Many of the home-care steps to treat TMJ problems can prevent such problems in the first place. Dr Krempa recommends avoiding eating hard foods and chewing gum. He often suggests relaxation techniques to reduce overall stress and muscle tension. It is important to maintain good posture, especially if you work all day at a computer. Pause often to change position, rest your hands and arms, and relieve stressed muscles.

Simple, gentle therapies are usually recommended first.
  • Learn how to gently stretch, relax, or massage the muscles around your jaw. Your doctor, dentist, or physical therapist can help you with these.
  • Avoid actions that cause your symptoms, such as yawning, singing, and chewing gum.
  • Try moist heat or cold packs on your face.
  • Learn stress-reducing techniques.
  • Exercising several times each week may help you increase your ability to handle pain.
Some common treatments are
  • Night Guards, Bite Guards, and Bite Adjustments are used to treat teeth grinding, clenching, and TMJ disorders. While many people have found them to be useful, the benefits vary widely.
  • The guard may lose its effectiveness over time, or when you stop wearing it. Other people may feel worse pain when they wear one.
  • There are different types of splints. Some fit over the top teeth, while others fit over the bottom teeth.
  • Permanent use of these items is not recommended. You should also stop if they cause any changes in your bite.

Ask your dentist about medications you can use:
  • Short-term use of acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or other nonsteroidal anti-inflammatory drugs
  • Muscle relaxant medicines or antidepressants
  • Rarely, corticosteroid shots in the TMJ to treat inflammation
If you experience any TMJ problems or symptoms, please let us know. Dr. Krempa will be happy to evaluate your situation and offer the best treatment possible.
Do you wake up feeling like you have not slept yet?

Sleep apnea is a sleeping disorder characterized by a complete or partial interruption in breathing during sleep. Sleep apnea may be caused by a lack of respiratory strength; however, it is more commonly caused by obstruction of the throat by the soft tissue (Obstructive Sleep Apnea). This obstruction narrows the space available for the air to flow resulting in a turbulent sound of air referred to as snoring. Snoring by itself is not an indicator for sleep apnea; however, in combination with other symptoms it is a good predictor.

75% of people have at least one of the following symptoms:
  • Daytime sleepiness
  • Moodiness
  • Decrease in attentiveness and drive
  • Morning headache
  • Loud snoring
  • Increasing body weight
Consult with your physician to see if a sleep study is appropriate for you. A sleep study must be done for diagnosis. There are many treatment options from behavioral therapy (sleeping on one side) to surgery. Continuous positive airway pressure (CPAP) is the most effective treatment for obstructive sleep apnea; however, 60% of CPAP users do not wear their mask on a regular basis. If you can’t tolerate wearing the CPAP machine mask or need an easier travel solution, you can have a custom made oral appliance as an alternative. The appliance will protrude your jaw increasing the posterior airway space. It is made up of 2 separate pieces and worn like an orthodontic appliance during sleep. The oral appliance keeps the soft tissue from collapsing and interrupting normal breathing patterns. It also allows you to speak, yawn and does not limit tongue space.
If you’ve tried CPAP and self-help tips and your sleep apnea persists, you may benefit from a dental device or surgical treatment. Most dental devices are acrylic and fit inside your mouth, much like an athletic mouth guard. Others fit around your head and chin to adjust the position of your lower jaw. Two common oral devices are the mandibular repositioning device and the tongue retraining device. These devices open your airway by bringing your lower jaw or your tongue forward during sleep. Dental devices are only effective for mild to moderate sleep apnea. There are also a number of troubling side effects from using this type of treatment, including soreness, saliva build-up, nausea, and damage or permanent change in position of the jaw, teeth, and mouth.
It is very important to get fitted by a dentist specializing in sleep apnea, and to see the dentist on a regular basis for any dental problems that may occur. You may also need to periodically have your dentist adjust the mouthpiece to fit better.
Dental xrays are a valuable diagnostic tool. They are one of the best tools to make important decisions about your oral health. For many patients, without dental x-rays, no meaningful discussions about oral health can occur.

Dental x-rays are a type of picture of the teeth and mouth. X-rays are a form of electromagnetic radiation, just like visible light. They are of higher energy, however, and can penetrate the body to form an image on film.

The test is performed in the dentist's office. There are many types of dental x-rays including:
  • Bitewing (patient bites on a paper tab and shows the crown portions of the top and bottom teeth together)
  • Periapical (Shows one or two complete teeth from crown to root)
  • Panoramic (Requires a special machine that rotates around the head. The x-ray captures the entire jaws and teeth in one shot. It is used to plan treatment for dental implants, check for impacted wisdom teeth, and detect jaw problems. A panoramic x-ray is not good for detecting cavities, unless the decay is very advanced and deep)
Most dentists will update these films between 6 months and 5 years depending on the type of image and the individual risk factors of the patient.

In addition, many dentists are taking x-rays using digital technology. The image runs through a computer. The amount of radiation transmitted during the procedure is less than traditional methods. Other types of dental x-rays can create a 3-D picture of the jaw.

The amount of radiation exposure is typically very small. Some studies have compared the amount of radiation from a set of bitewings to 2 hours of sun exposure.For this reason and others, most people feel comfortable and safe having prescribed xrays.

It is important to note that dental xrays are prescribed. Doctors prescribe this treatment when they believe the health benefits outweigh the health risks associated. In the case of dental xrays, most practitioners feel that the chance of getting a toothache or dental cavity far outweighs and is more common than the risk of developing side effects from radiation.

It is important to notify the dentist if you are pregnant, as certain precautions or alterations in treatment will occur.
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