Sometimes it seems that we will faithfully change the oil in our cars on a regular basis while putting off routine dental care for ourselves. . . unless we run into a speed bump such as a toothache. Pain is a powerful motivator, and a lot of us depend on emergencies or roadblocks like that to persuade us to change the road we’re on. But maintenance of your dental health can be one of the most important routines you can establish! Whether you are old or young, good dental care can even become the deciding factor in maintaining quality of life – or life itself. It’s not just a matter of filling cavities!

Probably the most widespread and insidious cause of dental health-related problems is gum disease. Studies indicate that 3 out of 4 adults will develop it in their lifetimes, and if you’re a man with gum disease, you’ll run twice the risk of a heart attack and three times the risk of a stroke. There is a strong connection between gum disease and diabetes; if gum disease is under control, most diabetics see an improvement in their overall health. Ladies, hormonal changes affect gum disease, especially if you are pregnant, and it can complicate pregnancy in a variety of ways. The development of rheumatoid arthritis may be aggravated by gum disease. And for those of us over 40, studies link gum disease with dementia. Who needs all that?

Don’t forget, each time a patient comes in for a procedure, Dr. Gotun always checks for any suspicious signs of oral cancer. Oral cancer is one of the deadliest forms because it so often goes undetected until it is advanced. It is becoming more common than some of the more well-publicized forms of cancer. Early signs are often subtle: most patients don’t even know they have it. It is not hard to diagnose, yet the survival rate is low just because it is often found so late. Smokers or those who chew tobacco run a special risk, but everyone diagnosed with human papilloma virus (HPV) should be checked on a regular basis, too. Any sore spot in your mouth that does not heal within 14 days should be seen, and we are here to help you if you need an appointment. Learn more about oral cancer…

Are you putting off getting those recommended fillings because you half-humorously tell yourself “I can always get dentures”? Do you like food you have to chew? Dentures are a good solution for severe problems, but they only provide about 10% of the chewing capacity of your own teeth. So if you like a good, chewy slice of ciabatta or you are a steak lover, plan to keep your own teeth!

In other words, the next time you look at that little sticker on the windshield and think it’s about time to schedule another oil change, let that be a reminder to take care of yourself as well. After all, you are more important than the car. Call for an appointment: we’ll be glad to “take a look under the hood” and keep you on the best route to good health!

Dr. Gotun and Staff.

TMD most often originates as a neuromuscular problem, sometimes due to dislocation or injury, sometimes genetic discrepancies, and sometimes it can be linked to arthritis; most often it is associated with stress. Symptoms include pain in and around the ear, chronic headaches or pain in the neck, tenderness of the jaw, or a clicking or popping noise when you open your mouth or yawn. As long as TMD is limited to the muscles only, we have a fair chance of improving the problem and sometimes correcting it altogether. If the problem is not addressed and becomes a joint problem (intracapsular problem), it becomes very difficult to obtain a permanent solution even though we manage to improve the condition.

Almost everybody has some level of TMD, but some cases become truly painful and interfere with our normal way of living. For certain patients, simple exercises relieve the problem. Relaxation and stress control are very important, too, because this can reduce the symptoms tremendously. But some cases are more severe. People suffering from TMD may have many different symptoms such as jaw pain, headaches, muscle spasms, fractured or loose teeth, ringing in the ears, swallowing problems and inability to chew, bite or open their mouths, earaches and many other combinations of symptoms that make their day-to-day life less fulfilling. That is why it is essential to diagnose the problem correctly and treat it in an inclusive way.

Each case is different. That is why we create an individual comprehensive plan to address the causes of the problems, in order to manage pain and eventually restore the masticatory system to the best condition possible. The best solution is to seek help at the first sign of problems. This allows us to address the disease before it ends up being non-responsive to any treatment.

We may also refer you for additional support to a trusted colleague in a field such as chiropractic or physical therapy to address other possible neuromuscular problems contributing to this condition. Some cases benefit from counseling, others from pharmaceuticals such as muscle relaxers, NSAIDs, or even antipsychotics. Dentox (a form of Botox used in dentistry) is effective, given the right circumstances.

Dr. Gotun has extensive training, which he constantly updates, as well as thirty years of experience in this area. In fact, he is one of the best neuromuscular dentists in the field.

Types of TMJ Disorders.

It is important to note that while the term TM Disorders is named for the temporomandibular joints, only 20-25% of patients have a pure joint-related problem. The rest suffer from a combination of muscular, joint and nerve pains that fit into the following broad categories:

• Joint related (internal derangements of the TM joint)
• Muscle related (myofascial pain and trigger points)
• Neck related (craniocervical disorders)
• Orofacial Pains
• Nerve related Orofacial Pains (neurogenic pain or neuralgias)
• Stress related Orofacial Pains (psychogenic and psychosocial pain disorders)

How we approach the treatment.

Dr. Gotun utilizes splint therapy, using different splints that serve specific purposes to address problems that manifest themselves due to the way the teeth come in contact with each other. There are many possible causes of such imbalances, and some of them can be partly or completely corrected. To do this, we use splint therapy of different levels. A splint is a highly accurate therapeutic plastic mouthguard specifically designed for you to restore a resting balance of the muscles in the masticatory system with the precision within 5/10,000“. The splint treatment often is followed by an equilibration (grinding of the surface of the teeth where needed to correct the imbalance) or by rebuilding the teeth with crowns, or both.

The different splints.

Diagnostic splint: This is a full arch maxillary (upper jaw) splint with an anterior ramp (front teeth resting on a 10° flat plane) balanced to approximate centric relation (joint seated in the desired location). The purpose of this splint is to test a person’s ability to use and benefit from a splint. The splint itself is produced by Dr. Gotun on models derived from your teeth by taking a set of alginate impressions. He also uses a tool called a face bow to relate the teeth to your joints. Finally, he takes a bite model using softened wax to accurately relate the upper and lower jaws. The models are mounted on a semi adjustable articulator (SAM 2). The result is a splint made of clear, thermally adapted plastic that snaps onto your upper teeth. The appliance is tolerated with no problems by most patients. The procedure takes two ½ hour appointments. The adaptation phase for each patient varies from no time to a week depending on each patient’s sensitivity level.

The fabrication of a diagnostic splint is preceded by:

a. General oral exam.

b. Limited TMD exam.

Night time splint: This is a full arch maxillary (upper jaw) splint with a full arch ramp (all posterior teeth resting on a plane with equal contact on each individual tooth) balanced to approximate centric relation (joint seated in the desired location). The splint itself is produced by Dr. Gotun’s laboratory affiliate on models derived from your teeth by taking a set of alginate impressions. He also uses a tool called a face bow to relate the teeth to your joints. Finally he takes a bite model using softened wax to accurately relate upper and lower jaws. The models are mounted on a semi adjustable articulator (SAM 2) to produce the appliance of a heat cured, clear, very hard and durable material that snaps onto your upper teeth. The purpose of this splint is to allow a patient to rest comfortably at night as a result of the appliance’s ability to distribute clenching or grinding forces equally throughout the muscles of the masticatory system (generally speaking, the muscles of your face controlling the function of your jaw). The splint also eliminates the neurological feedback to your brain of the upper and lower teeth’s relationship to each other. This facilitates the initiation of a neuromuscular balance of the masticatory system and thereby limits the resulting discomfort of biting your teeth together subconsciously. The appliance is tolerated with no problems by most patients. The procedure takes three to four 1-2 hour appointments. The adaptation phase for each patient varies from no time to a week depending on each patient’s sensitivity level.

The fabrication of a night time splint is preceded by:

a. General oral exam

b. TMD exam

c. Cone Beam CT scan presently done by ImagDent using an iCAT radiographic volumetric scanner

d. Radiographic interpretation by a oromaxiofacial radiologist

e. The mouth needs to be free of pathology (cavities, gum disease and other pathology) to obtain a predictable outcome

Full time splint: This is a full arch maxillary (upper jaw) splint with a full arch ramp (all posterior teeth resting on a plane with equal contact on each individual tooth) balanced to approximate centric relation (joint seated in the desired location) much like the night time splint. The splint itself is produced by Dr. Gotun on models derived from your teeth by taking a set of alginate impressions. He also uses a tool called a face bow to relate the teeth to your joints. Finally, he takes a bite model using softened wax to accurately relate upper and lower jaws. The models are mounted on a semi-adjustable articulator (SAM 2). The result is a splint made of clear, thermally adapted plastic that snaps onto your upper teeth. The purpose of this splint is to allow a patient to rest comfortably 24 hours a day as a result of the appliance’s ability to distribute clinching or grinding forces equally throughout the muscles of the masticatory system (generally the muscles of your face controlling the function of your jaw). The splint also eliminates the neurological feedback to your brain of the upper and lower teeth’s relationship to each other. This facilitates the initiation of a neuromuscular balance of the masticatory system and thereby limiting the resulting discomfort of biting your teeth together subconsciously. The appliance is tolerated with no problems by most patients. It is worn 24-7 and the teeth are not allowed to touch during the whole course of splint therapy without the splint in place. The duration of treatment is 6 weeks to 6 months. There is an adjustment and measurement appointment about once a week during the total treatment. The end result is a repositioning of the jaw to a functional and comfortable position that is followed by whatever treatment is necessary to maintain this relationship indefinitely. The initial fabrication of this splint is the same as the night time splint. The subsequent appointments last anywhere from 15 to 30 minutes. The adaptation phase for each patient varies from no time to a week depending on each patient’s sensitivity level. After a stable position is obtained and pain, popping and crepitation symptoms are at an acceptable level, final treatment is planned after a pantographic analysis (a 100% duplication of jaw function onto a fully adjustable articulator) is performed. This could include any of the following treatments or a combination:

a. Equilibration (adjustments of teeth by grinding on the biting surface of the teeth)

b. Crowning of teeth

c. Braces

d. Orthognatic surgery (surgical approximation of upper and lower jaws)

e. Joint surgery

Other approaches to TMD therapy.

Injection therapy: As long as we are dealing with muscle malfunction, several forms of injection therapy can be utilized.

a. Steroid injection: Overworked muscles often develop “trigger points”. These especially sore areas of the muscle feel like hard ball-shaped spots in the tissue that can be very tender to touch. By first numbing these spots and then injecting them with a steroid solution, it is possible to reduce the inflammation. In addition, through exercise and relaxation, sometime also using a variation of cold and heat packs, the initial “bump in the road” can be improved. A follow up with night time splints and eventual permanent bite corrections can render drastic improvement.

b. Dentox (Botox A) injection: The level of activity of specific muscles can temporarily be reduced by using Dentox judicially. A thorough exam as for a full time splint is imperative. Misuse of this drug can temporarily cause undesired side-effects, such as reduced chewing ability and facial asymmetries. Dentox lasts for 4-6 months and the drug is very effective given in the right circumstances. The treatment needs to be repeated every 6 months to keep the TMD problem under control. It is a pain management strategy, but it does not solve the underlying problem of stress and tooth/jaw malalignment.

Physical therapy / chiropractic manipulation: A component of TMD problems that is related to bad posture and normal wear and tear relating to physical activity of different levels. Granted, people with a lot of accidents are more prone to residual problems than most. Any accident that can be described as a sudden impact relating to an accident or a sports related injury certainly can be contributing to a life of muscle problems and joint malfunction. The possibilities are vast and the results often misdiagnosed. Thorough evaluations of postural problems by qualified professionals are very important and should never be overlooked. Dr. Gotun frequently involves other professionals to evaluate the general health of his patients. There is a wide variety of possible contributing factors and if ignored, the consequences can be devastating.

Drugs: We live in a society that enjoys an enormous amount of effective drugs to help us cope with undesirable physical and mental problems. One of the sad facts of life is that many of them are not curing the problems but rather limiting the perception of the seriousness and the extent of the disease by an individual and thereby contributing to escalation of the problem by dulling the symptoms. For example, we can walk on a broken leg if we are under the influence of pain medication strong enough to hide the actual pain and original damage. But in spite of that, we also can, under proper supervision, use drugs to speed up healing and recovery.

NSAIDs: Some of the best helpers if used over a short period of time are categorized in a group called the nonsteroidal anti-inflammatory drugs (NSAIDs). Some of these are Ibuprofen, Aspirin, Advil, Tylenol, Naprosyn

and many more.

NSAIDs can be broadly classified based on their chemical structure. NSAIDs within a group will tend to have similar characteristics and tolerability. There is little difference in clinical efficacy among the NSAIDs when used at equivalent doses. Rather, differences among compounds tended to be with regards to dosing regimens (related to the compound’s elimination half-life), route of administration, and tolerability profile. Some more common examples are given below.

a. COX-2 inhibitors

b. Celecoxib (FDA alert [1])

c. Etoricoxib FDA withdrawn

d. Lumiracoxib TGA cancelled registration

e. Parecoxib FDA withdrawn

f. Rofecoxib (withdrawn from market [2])

g. Valdecoxib (withdrawn from market [3])

h. Sulphonanilides

i. Nimesulide (banned by several countries for the potential risk of hepatotoxicity)

j. Ibuprofen[4]

k. Naproxen

l. Diclofenac

m. Licofelone

n. Licofelone acts by inhibiting LOX (lipooxygenase) & COX (cyclooxygenase)and hence known as 5-LOX/COX inhibitor

To make a long story short: NSAIDs used for a short period of time to reduce inflammation and pain are a very useful tool, but used indefinitely, NSAIDs can cause all kinds of physical problems which might not show up immediately. Problems like upset digestive system and even cancer can develop in some circumstances. NSAIDs used in conjunction with the aforementioned therapies are known to drastically boost the healing speed.

Muscle relaxers: Muscle relaxers like Diazepam (Valium) are in a group of drugs called benzodiazepines. When treating TMD, a small dose of the drug is taken right before bed time. It helps people sleep and it drastically reduces muscle hyperactivity. Used over a short period of time, for instance 10 days, some of the stress inducing TMD can be managed and healing can begin, in particular if it is used in conjunction with some splint or injection therapy. Diazepam used over longer periods is habit-forming and loses its therapeutic effect. It should not be used unless it is prescribed and supervised by a licensed professional.

Pain medication: Drugs containing codeine or hydrocodone like Vicodin, Lorcet and the like are far from the treatment of choice. Generally the medication creates an altered perception of the pain and has no healing effect. These kinds of drugs should only be used in extreme cases where there is an overwhelming need to limit pain immediately for a short period of time.

Other alternatives: TMD has been a disease that has been around forever. People that complain about headaches often have a TMD component that is part of the trigger mechanism. Healthy living, good eating habits, reduction of stress and increase in exercise are important contributing factors to promote the healing. There are special relaxing exercises that can be helpful. Reestablishing good posture and awareness of how you sit and function in your day-to-day active life are a must. Also, studying your sleeping position and sleeping habits are part of finding out what can be improved to promote healing.

The good news is that no matter the mildness or severity of TMD conditions, there may be ways to approach the problem and achieve a positive result. If you suspect you have TMD, or have been given a diagnosis that you do, the sooner you make the decision to do something about it, the more likely you will be to achieve a favorable outcome. The keys to success are a comprehensive approach to treatment and full cooperation from the patient. The right combination of treatment options, addressing contributing factors, and changes in one’s lifestyle can do miracles for even the most seemingly hopeless conditions. Dr. Gotun is well known for his expertise in TMD treatments, and there is no doubt that choosing our practice to help you is a great first step. We have the knowledge, expertise and experience in helping cases like yours. We always welcome your questions at 512-329-5555.

We are ready to help you heal whenever you are ready, too.

The desire to have whiter teeth is very widespread, although it is not indicated for everyone. For example, if you have chipped or uneven teeth, bleaching generally enhances the discrepancies; if you have teeth sensitive to hot or cold, bleaching will increase this sensitivity. When determining how white your teeth should be, look into a mirror in natural light.Your teeth should be approximately the same color as the whites of your eyes (if your eyes are healthy). If teeth are bleached whiter than this, they can look unnatural or false.

For patients wanting teeth whitening, we require a complete examination and full set of x-rays less than 3 months old to be on file before you start. This is to ensure that your teeth are healthy enough to handle any chemical side effects, which can be unpleasant in some cases. We also recommend that you have all necessary fillings addressed before bleaching so there are no cavities or dark restorations. Fillings bleach differently than teeth, and as a result, there might be color variations in your mouth that you might not desire. If you have crowns, keep in mind that they do not bleach.

The process takes two appointments. The first appointment is for impressions to create your own individual bleaching tray, and takes about half an hour. The second appointment takes only a few minutes. Your bleaching tray will be seated and checked for fit, and you will receive instructions on how to use it.

If you know you have sensitive or uneven teeth, consider veneers or crowns as alternatives to bleaching. They often offer a better solution for stained and chipped or broken teeth! If you have a single discolored tooth, internal bleaching may be the best solution.

Photos help us diagnose your oral health at a higher magnification than with the naked eye or using magnification loops. They give us an opportunity to show you what we see, and you will be able to see the problems for yourself, which in turn will help you make informed decisions about your treatment options. Photos are a great tool for us and they help us in monitoring your status or changes. They also enable us to answer questions in a way that is easier to understand, as they are a great visual aid.

Dr. Gotun has worked with dental implants all his career, but he has always been very conservative in their application, as for many years implants were very complicated to deal with and were quite an unpredictable solution to missing teeth. The technology evolved and with it, of course, Dr. Gotun. He believes that now, finally, the newest digital technology is precise enough that the outcome of implants is more predictable and has fewer side-effects. It is now a safer alternative to bridges and dentures than in the past. We are pleased with these improvements and are ready to answer your questions about them. Although the technology used currently in various offices is pretty much the same, there are differences in approach and philosophy. While some can offer same-day implants, Dr. Gotun prefers to proceed with caution, doing thorough diagnostics and treatment in stages, to observe the progress and make sure that he achieves the best possible result for an individual. After all, it is a very elaborate process and different people respond to it in their own unique ways. Here is some basic information for those of you interested in implants:

Implants are a good solution for anyone healthy enough to have adequate bone to support them. An implant consists of an artificial root surgically anchored in the jaw, which is then capped with a crown. Implants are meant to be permanent, natural looking and comfortable solutions for missing teeth. They are true replacements for each missing tooth. They enable you to bite and chew food in a completely normal way. In some cases, implants can also anchor a bridge so that the patient has a fixed denture, rather than a partial removable type, and that added security can make a huge difference in how comfortable a denture wearer may feel smiling, laughing or eating in public.

Whether you need one implant or several, the process is the same. For a patient to be a candidate for implants, he or she must be in good general health, have adequate bone in the jaw to accept the implant, be prepared for a process that will take at least 6 months to complete, and be committed to regular dental hygiene visits. Please give us a call if you would like to ask Dr.Gotun about implants for you.

Celebrating Hard Work, Determination and Expertise:

Lance Armstrong and the Tour de France,

Michael Phelps and Olympic Gold,

Tor Gotun and a Masters in the AGD!

Dr. Tor Gotun

We are proud to announce that Dr.Gotun has been awarded the highest honour a dentist in the Academy of General Dentistry can achieve – a Mastership. Currently only 1% of the dentists in the world hold that title. Only dentists with extraordinary dedication to continuing education and constant improvement of their skill and knowledge get this level of recognition.

To make it simpler to understand the implications of this title – it is like earning an Oscar or an Olympic gold medal. The ratio is pretty similar. In 50 years of the existence of the Academy of General Dentistry, only 2500 of these awards have ever been given out. Austin has a reason to be proud of its dental community, as there are seven Masters of the Academy of General Dentistry in town. The dentists that have achieved that designation are believed to have reached the pinnacle in the dental knowledge and skill. The only logical next step for Dr.Gotun is spending more time on teaching other dentists in the country and… more continuing education! As we are sure you know – he will never stop learning!

Even though Dr. Gotun may not be a movie star, we are still very proud! More than ever can we say that we do deliver the best in dental care!

Congratulations, Dr.Gotun!

Dr. Gotun’s pursuit of excellence in dentistry is largely a result of his efforts to help people. It is the unique conditions of his patients that are the inspiration for constant self-improvement that lead to the invention of solutions that do not exist in the broader dental world. Some of these solutions are so outside of the textbook that Dr. Gotun now has a lot of new knowledge to share with new generations of dental professionals. Many cases have been solved against all mainstream dental beliefs due to the patients’ willingness to try new techniques and their persistence through the stages of dental treatment.

During this remarkable journey to suceed in seemingly most hopeless of the situations, rarely tried by most, much less achieved, Dr.Gotun felt rewarded over and over again. How?  By resolving the hardest of dental puzzles and creating healthy, beautiful smiles on the faces of patients who hadn’t believed they could have them. You, our valued and loyal patients, are the reason why Dr.Gotun is where he is right now.

Thank you very much for being the inspiration and support for Dr.Gotun through all these years!

Our goal is to find and treat the underlying causes of problems, not just the symptoms.

Although all of the dental community follows the same medical standards, all dentists are unique in their own ways. There is a difference in experience, education and overall expertise. But most importantly, some medical professionals choose a philosophy that differs from others. That is the beauty of the art of dentistry. Often in medicine, there are no simple answers, because no two bodies are the same. It is the same in dentistry. Our mouth does not function separately from our body, and therefore it should be treated as such. We all have physical and personal characteristics that have to be taken into consideration for the diagnostics to be accurate and for the treatment to be effective. Because of this, the approach has to be altered for each individual case. We do not take the easy route. We make sure we do it right the first time. This is how Dr. Gotun practices dentistry.

Dr.Gotun’s philosophy is uncompromised quality of care for the best possible outcome in the long run for even the most hopeless of dental conditions.

Over 30 years of experience and well-known excellence in dental care in Austin and Texas have polished Dr. Gotun’s techniques and methods. He chooses only the best and most efficient up-to-date technologies, materials and techniques that have proven to work long-term, have fewer side-effects, are the least invasive and that ensure the most effective dental care for his patients. Dr. Gotun has extensive experience and advanced training that enables him to create unique individual solutions for his patients. Some of these solutions are so outside of the textbook that Dr. Gotun has spent years sharing his knowledge with new generations of dental professionals.

“ I cannot wait to wake up in the morning and get to work! I love what I do and I will practice dentistry as long as I physically can!” This statement by Dr. Gotun says it all. Think about this for a minute:  What is there in your own life that makes you feel as passionate? You will feel and appreciate the difference this attitude can make in getting the care you need!

Some can consider our practice non-mainstream and that is exactly what a lot of people are seeking, when their condition cannot be successfully resolved or managed by the standard of care. Dr. Gotun’s integrative approach has been very successful for many years and many cases have been solved against all mainstream dental beliefs. Our patients appreciate his philosophy and we are proud that many of them have stayed with him his entire career. We have patients who have moved out of state who still come back annually to have their care here!

IMPRESSIONS AND MODELS. To complete the exam, we take impressions of your upper and lower teeth and gums to create study models. These are 3-dimensional models that show us how your teeth work together. We will put these models on a tool called an articulator to correctly demonstrate how your teeth truly fit (or in some cases, do not fit) together. Simply taking the models and stacking the upper jaw casting over the lower one does not depict the actual interaction of the jaws (relationship between tooth positioning and joint function), so the articulator is necessary.

To find out your individual anatomical jaw position we use a measuring tool called a face-bow, which is a means of measuring how the teeth relate to the jaw joint (temporomandibular joint). When these measurements are incorporated into the articulator holding the upper and lower jaw models, the result is an accurate depiction of how your mouth functions. These diagnostic casts are a means to study flaws or problems, and communicate them to you, the patient. We also use these initial models as a reference if further work needs to be done.

All of these procedures are done very gently with the patient’s comfort and individual needs in mind.

In order to have accurate, adequate information that enables us to treat you as effectively as possible, we take multiple x-rays. As some people are concerned about the radiation from x-rays, here are some facts for your consideration:

1.    The amount of radiation you’re exposed to in our practice is the approximate equivalent of about 5 minutes’ worth of being outside in the shade on a sunny day. It is miniscule compared to a chest x-ray and is absolutely safe.

2.    If you think you may be pregnant, please make sure you let us know and as an additional precaution we will not take x-rays.

There are several different types of x-rays, which we use for different purposes at different stages of diagnostics:

1. A “full mouth” set consists of 4 bitewing x-rays and 14 periapical x-rays. They show us what we can’t see with the naked eye: with these 18 different views, we can see each tooth individually and from different angles or positions, including the roots and bone in the jaws. This is how we create a correct picture of the extent of cavities or other defects. Taking just 1 or 2 x-rays, though appropriate in an emergency situation where you have pain with a single area of the mouth, may or may not pick up cavities, especially if they are small. The more x-rays we take the more information we have and the more accurate is our diagnosis. When you come in for a regular full exam, we take a full mouth set of x-rays.

2. A “panoramic” x-ray gives us a more rounded view of the teeth and their relation to the jaws. We can see major structures such as the sinuses, the nerve pathways and the location of the wisdom teeth. If you need surgery or extractions, this information is vital to the ease and success of the procedure.

3. Another type of x-ray is the cephalometric, which may be taken from the front of your head toward the back, or from the side. We use these in some orthodontic cases, if there has been trauma, or if we suspect temporomandibular disorder. These views give Dr. Gotun an idea how the patient deviates from a standard pattern of growth and how this needs to be corrected.

4. Occlusal x-rays are taken from the top of the head toward the chin or vice versa, and are very useful in revealing such problems as supernumerary teeth (too many teeth, some of which may not have erupted yet) or problems infiltrating the upper jaw and facial area.

5. One of the most important new diagnostic techniques is “cone-beam” computer tomography. It is especially useful for diagnostics in relation to TMD, orthodontics, surgeries or implant planning. This technology uses a scanner able to collect data to create a complete volumetric reconstruction of a patient’s head and jaws. This 3D model reveals incredibly precise details of bone density and the structures of the face and mouth. The use of this technology assures you as a patient that if a complex procedure is required, we have the most accurate information possible to plan our approach and achieve the best results.

Although it’s rare that we need every type of the x-rays we’ve just described, these are some of the diagnostic tools that may be used to form your unique, accurate diagnosis. In turn, that allows us to discover and address the causes of any problems you may be experiencing, not just the symptoms, which makes the treatment efficient.

Regular visits to your general dentist are key to maintaining healthy teeth and gums. Tooth decay and gum disease are the biggest risks for adults who don’t receive regular dental care.
Besides being destructive to your teeth, gum disease is an oral infection that is contagious and it can be transferred to family members and loved ones.  In addition, gum disease has been linked to heart disease and strokes.
Untreated cavities will eventually cause pain, and it can lead to losing teeth.  Tooth loss is a big problem. If you think dentures can make up for it, remember that your chewing capacity will be reduced to about 10% of normal. Because of the reduced ability to chew, digestion also gets affected, especially the processing of all-important fiber in our food.  So, malnourishment can be the result, leading to a decline in overall health.  Also, dentures can be uncomfortable, and even a good fit initially can change over time.  Using dental adhesives often leads to rampant yeast infections – another problem that can affect your health in general.  There is also a link between denture use and stomach cancer.  These are just a few of the reasons why it is so important to treat cavities!

In our office, in addition to preventive care that Dr. Gotun performs himself, he does free oral cancer screenings every time a patient is in the dental chair. We have seen many examples where our diagnostics were essential in prevention or treatment of oral cancer.

General dentists are the primary dental care providers for patients of all ages. Besides providing preventive services, your general dentist is responsible for the diagnosis, treatment, management and overall coordination of your oral health needs. If you need the services of a specialist, such as an oral surgeon or endodontist, your general dentist can provide appropriate referrals and maintain your continuity of care. Dr. Gotun has very extensive training (his knowledge and expertise put him in the top 1% of the dentists in the US) and he can provide his patients with all aspects of dental care under one roof.

Building a trusting relationship with a dentist who sees you regularly and knows your history allows you to maintain your oral health and catch small problems before they become big ones. Continuous monitoring of your dental health and easy access to your dentist in case of emergency is important and convenient if provided. Dr. Gotun’s patients are guaranteed to get an appointment the same day in case of emergency if they call in the morning within working hours.

Another important aspect of Dr. Gotun’s dental care is that we do not double-book anybody. The appointment time is reserved only for you, so there is no waiting time and you get Dr. Gotun’s undivided attention. He dedicates a lot of time to patient education, so he takes the time that is needed to explain why and how things can be done in each individual case. Dr. Gotun takes pride in delivering only highest quality care for the whole family; therefore we choose to limit our patient flow in order to be able to provide the level of quality in dental care that we strive for.