Dr. Ciuffreda has been recognized as an “America’s Top Dentist” and “NJ Top Dentist” for General Dentistry and an “America’s Best Dentist” for Family Dentistry.
Routine checkups and cleanings
Regular dental checkups and cleanings, along with good home care, are the cornerstone of optimal dental health.
This of course all begins with your first visit. Dr. Ciuffreda always schedules an hour for a new patient examination; during which time we will review your medical and dental history including any particular issues or concerns you may have, perform an oral cancer screening, take and review a set of digital radiographs (x-rays), and conduct a full soft tissue/periodontal (gums) and hard tissue (teeth) exam.
Dr. Ciuffreda then will review his findings with you, discuss different treatment options, and take whatever time is needed to thoroughly answer your questions about your treatment plan. Most times you will also receive a professional tooth cleaning (prophylaxis) at this visit.
Dr. Ciuffreda will recommend a frequency for you to return for regular checkups and cleanings based upon his findings. Generally speaking, we advise seeing our patients at least every 6 months to maintain excellent oral health.
Periodontics is dentistry dealing with diseases of the gums and other structures around the teeth. There is a growing body of research that demonstrates a relationship between periodontal disease and systemic health issues.
Periodontal Disease encompasses a progressive range of conditions that most often has its beginnings as gingivitis – inflammation of the gums surrounding the teeth as a result of bacteria and plaque buildup. Chronic inflammation of the gums can then result in deterioration and loss of the bone that supports the teeth, and ultimately lead to tooth loss. Dr. Ciuffreda is passionate about maintaining the periodontal health of his patients because that is the foundation for any other treatment that is done for the teeth.
Initial treatment of periodontal disease most often involves scaling and root planning, otherwise known as “deep cleaning.” This involves gently numbing the region to be treated, and removing plaque and calculus underneath the gum line.
Fillings and Crowns
Smaller areas of tooth decay are usually restored with fillings. Dr. Ciuffreda almost exclusively uses tooth colored, bonded filling material (also known as “composite”) for these procedures. The advantages of bonded fillings include (as the name implies…) actual bonding of the restoration to the tooth; most times the ability to do a much smaller restoration, thereby conserving natural tooth structure; and of course outstanding esthetics. One aspect of cosmetic dentistry that Dr. Ciuffreda finds particularly rewarding is when he is able to blend a bonded filling into a tooth so that you can’t even tell that a restoration was done at all.
Dr. Ciuffreda has been recognized as an “America’s Top Dentist”, “America’s Best Dentist”, and “Monmouth Health and Life Top Dentist” for Cosmetic Dentistry.
Crowns involve the reduction of more tooth structure and may be warranted for several reasons, including inadequate remaining tooth structure, following endodontic (root canal) therapy, or for cosmetic enhancement. Crowns are most often fabricated of either special all-porcelain materials (such as zirconia and e-max) or porcelain fused over high gold content metal (PFM). All-porcelain crowns typically provide the best cosmetic result as they allow for a degree of translucency as with natural tooth structure, and also eliminate the possibility of the “dark line” effect at the gum line that may sometimes occur with PFMs. Dr. Ciuffreda reviews an x-ray is taken of all crowns prior to final placement and cementation to ensure that they are perfectly fitting and provide the best possible seal to the underlying tooth structure.
Bridges are one treatment option for the restoration of missing teeth (or failing teeth that require extraction) and are comprised of multiple crowns joined together. Teeth on either side of the space are prepared (reduced) which serve as the anchoring points for the restoration. As with single crowns, bridges are most often fabricated of either special all-porcelain materials (such as zirconia) or porcelain fused over high gold content metal (PFM). All-porcelain bridges typically provide the best cosmetic result as they allow for a degree of translucency as with natural tooth structure, and also eliminate the possibility of the “dark line” effect at the gum line that may sometimes occur with PFM bridges. . Dr. Ciuffreda reviews an x-ray is taken of all crowns prior to final placement and cementation to ensure that they are perfectly fitting and provide the best possible seal to the underlying tooth structure. Bridges provide an esthetically pleasing, strong and functional solution to restore spaces due to tooth loss.
Dr. Ciuffreda has been recognized as an “America’s Best Dentist” and “Monmouth Health & Life Top Dentist” for Implant Dentistry.
Dental implant restoration is one of the most exciting and rewarding treatment options available. Implants may be used to restore a single tooth, several teeth, or even the entire mouth. Treatment plans can include fixed or removable alternatives. Working in conjunction with a surgical specialist, Dr. Ciuffreda has the ability to provide you with a restorative option having the highest long-term success rate available today for a missing or failing tooth or teeth.
Implants have many benefits:
- The restorative phase of implants is almost always entirely painless.
- They do not require the drilling of adjacent teeth (as would be needed for a bridge)
- The implant acts as an “artificial root” and actually helps preserve bone in the formerly toothless site. Without forces acting on the jaw bone, through either a tooth or implant, the bone in that area can actually resorb, or deteriorate. This deterioration of bone can sometimes lead to cosmetic or functional issues.
- Because an implant consists of titanium, gold and porcelain, there is no organic component to decay – in other words you can never get a cavity (decay) on an implant.
- The long term success rate of implants has been reported as high as 98%.
- Implants are “biomimetic” compared to a bridge. In other words biologically speaking, we naturally have individual teeth, not teeth joined together.
After a tooth has been extracted (in the case of a single tooth restoration), a dental surgical specialist will carefully place a titanium implant into the bone of the jaw. Approximately 3-4 months following successful integration of the implant with the surrounding bone, Dr. Ciuffreda will begin the restorative phase – which is almost always entirely painless, normally does not even require an injection to get numb, and does not require any drilling! The first restorative visit involves unscrewing a cover screw and taking some impressions. (It’s no wonder patients are so relaxed having implants restored…). At a subsequent visit, the cover screw is again simply removed, and the implant abutment (or “post”) is tried in. Dr. Ciuffreda always reviews an x-ray of the placed abutment to ensure that it is perfectly seated. The abutment and crown are then delivered either entirely screw retained or a combination of screw retained abutment and a cemented crown.
Dr. Ciuffreda has had wonderful success with implant cases, ranging from a single tooth to complete upper and lower full mouth implant restorations / reconstructions.
Full & Partial Dentures
Whenever advisable, Dr. Ciuffreda definitely prefers fixed (that is, non-removable) treatment options such as crowns, bridges and fixed implant restorations because of the superior chewing ability that they provide. However, there are instances where partial or full dentures are indicated clinically, such as if there is inadequate bone for a surgeon to place implants or too few remaining good support teeth for a bridge. Additionally, full or partial dentures may provide a less expensive financial alternative, or they may be used as an interim (temporary / transitional) restoration as part of your overall case.
Dr. Ciuffreda is a recipient of the Arthur N. Caplin Award for Removable Prosthodontics.
Root Canal Therapy
Root canal (endodontic) therapy is generally indicated when the nerve of the tooth becomes compromised by decay, irreversibly irritated / inflamed, or becomes necrotic (dies). What is often confusing to patients is that teeth that may require root canal therapy are not always painful, but they certainly can be. After making sure the patient is numbed comfortably, root canal therapy involves the removal of the tooth nerve/pulp, cleaning of the canal(s), and filling / sealing of the canals. Following endodontic therapy restoration with a crown is almost always indicated for structural stability and restoration, as the absence of the internal blood vessels within the tooth now leave it dry and brittle, thus more susceptible to fracture.
TMJ / Headache
Dr. Ciuffreda has been awarded the status of Diplomate of the American Academy of Pain Management, and has been accepted into membership of the American Academy of Craniofacial Pain. He holds certificates for the NYU College of Dentistry, Institute for Advanced TMJ Stuidies, and the UMDNJ Post Graduate Programs in Orofacial Pain.
The term “TMJ disorders” (also referred to as TMD), as commonly used by patients, represents a broad array of jaw joint, occlusal, and musculoskeletal conditions of the head & neck. As the classification encompasses a wide range of conditions, there naturally are many signs and symptoms of TMD. Some of the more common ones include:
– pain in front of the ear
– tender or painful jaw muscles
– clicking, popping or crunching noises when opening or closing the jaw
– limited opening or locking of the jaw
Headaches or general head / neck pain may also be associated with TMJ disorders. (See the section on headaches below.)
Such problems require comprehensive evaluation by a dentist with advanced training in this area. In evaluating a patient with symptoms of a potential TMJ disorder, our office combines the results of your medical history / questionnaire, x-rays, and a detailed examination of the head & neck to arrive at your diagnosis. Referral for imaging such as a CT scan, MRI, or iCAT may be indicated.
Due to the potentially complex nature of such disorders which often involve many contributing factors, our treatment approach is one of the whole person as a system to restore harmony and balance to your TM joint / head & neck functioning. Common therapeutic approaches may include the use of an oral appliance, occlusal equlibration (adjusting the “bite”), specific jaw exercises, and the use of moist heat. We may also work with other medical specialists depending upon your individual needs, and may advise referrals for evaluating nutritional considerations, , general exercise, lifestyle, work habits and daily living changes, and stress reduction / relaxation suggestions.
We have had tremendous success with our integrative, conservative, non-surgical approach to the treatment of our TMD patients. In fact, this ability to provide such profound relief from chronic debilitating pain is one of the most rewarding aspects of our practice!
Headache is one of the most common medical complaints of the U.S. population today and actually accounts for millions of lost workdays each year. Due to the wide range of apparent symptoms and presentations of head pain, the International Headache Society has developed a comprehensive classification in an attempt to categorize these disorders.
Our experience in treating these disorders has shown that the large majority of patients who complain of unilateral headache (pain on one side) often have a muscular / myofacial (MPDS) cause of their discomfort; and a large percentage of the time are associated with an actual TMJ (actual joint involvement) disorder. The most common (although not the only) location for this type of headache is around or above one eye, travelling up from the neck on the same side.
If there is an associated TMJ disorder and/or bruxism (tooth grinding), an oral appliance is usually essential to achieving relief. Such headaches of muscular origin have been quite successfully treated at our office. Coordinated referral to a physical therapist, occupational therapist, chiropractor, or a well trained massage therapist is often highly beneficial.
Dr. Ciuffreda has seen numerous patients who provide a history of “migraine.” Frequently these patients have been placed on prescription migraine medication but have had only limited, if any relief. However, upon examination Dr, Ciuffreda frequently finds that they really have a muscular / myofascial type headache often associated with a TMJ disorder and/or bruxism. that can usually be alleviated without, or with minimal medications as discussed above.
RED FLAGS OF HEADACHE
Not all headaches are “just headaches”. There are certain signs or symptoms that may indicate a serious underlying cause for headache symptoms. If you experience any of the following it would be highly advisable for you to seek medical consultation promptly:
– abrupt onset of different or new type of severe headache
– “worst headache you have ever had”
– new onset of headache if over 50 years old
– worsening of a headache over a period of days or weeks
– headache worsened or precipitated by exertion
– presence of illness, fever, nausea, vomiting, stiff neck
– neurological symptoms (different from classic pre-migraine signs)
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