Comprehensive Dental Exam

Our comprehensive dental exam includes an overall evaluation of your teeth, gums, bones and other soft tissues.

The First Visit

Every patient entering this office will be given a thorough health history questionnaire. If is imperative that the questionnaire be filled out as accurately as possible. Certain medical problems may require special precautions before any dental treatment can be performed. For example, a person with cardiac valvular disease would require antibiotics before dental treatment. Also, please update us if your medical status ever changes.

In addition to the medical history, the following procedures will be performed to rule out not only dental disease but also other soft tissues diseases such as oral cancer:

  1. Examination of the head and neck and the soft tissues of the mouth including the lips, cheeks, palate, oropharynx, tongue, and floor of the mouth
  2. Examination of the occlusion (bite) including diagnostic cast models if indicated
  3. Examination of the periodontium (gums)
  4. Examination of the teeth, visually
  5. Examination of the teeth and bone through radiographs (x-rays)
  6. Evaluation of oral hygiene
  7. Evaluation of the dental restorations
  8. Evaluation of any other conditions present

Your teeth and mouth are important to your health, oral function and facial development, as well as your appearance and confidence. If during the examination you have special concerns or desires, please bring them to our attention.

Following the examination, a diagnosis and treatment plan or plans will be presented to you. If any specialized treatment is required, a referral will be made to the appropriate dental specialist or physician.

Oral Cancer Screening

As part of the comprehensive examination described above, the soft tissues of your oral cavity will be thoroughly examined for oral cancer. Oral cancers are rare with about 40,000 cases per year in the U.S. However, it is important to note that certain behaviors greatly increase your risk to develop the disease such as smoking, chewing tobacco, drinking alcohol excessively and sunbathing. Sexually transmitted diseases such as human papilloma virus can also lead to oral cancer. Therefore, if you engage in any of the above activities you are at an increased risk for developing oral cancer. If you develop a sore in your mouth which is persistent, is firm to the touch with irregular borders, painful and will not heal, it is important you have the lesion examined. If neccessary a biopsy will be performed and sent to a laboratory for pathological examination. If Dr. Zegarelli sees a lesion he feels is suspicious, he will schedule an appointment for a biopsy. It is important to note and remember that the vast majority of lesions found in the mouth are benign. Sometimes these benign lesions may also need to be biopsied to rule other dermatologic diseases of the mouth.

Dental Emergencies

Tooth aches and swellings occur. When you have one contact our office as soon as possible. Every effort will be made to see you and treat you as quickly as we can. If you have a swelling, please inform the receptionist of this condition as dental swellings can lead to more severe consequences. Accidents also can occur. Again contact this office as soon as possible. The goal of emergency treatment is to take the patient out of pain and to treat any infections so they do not spread.

Most dentists reserve time in their daily schedules for emergency patients. Call your dentist immediately and provide as much detail as possible about your condition. Remember, pain is a signal that something is wrong. Even if the pain subsides, this does not mean the problem will disappear. You must see your dentist and have them treat the injury.

Periodontal Therapy

Periodontal disease is a chronic inflammatory disease that causes swelling and redness of the gums. It attacks the bone, gums and other supporting structures of the teeth. Dental plaque is the primary cause of periodontal disease. When plaque is not removed, it can turn into dental calculus (tartar), which may further aggravate the periodontal disease process. You can prevent dental plaque by practicing good oral hygiene. This means brushing and flossing daily and visiting the dentist for regular checkups and dental cleanings. Periodontal therapy is used to treat the early stages of periodontal disease. This technique utilizes scaling and root planning, topical solutions, bite correction and laser therapy. It is important to remember that recent studies have suggested a link between periodontal disease and heart disease, diabetes, stroke and premature births among other maladies. So a healthy mouth can lead to a healthier body. If you have a more severe form of the disease, a referral to a periodontal specialist may be advised.


Children are welcome to our practice. Your child will receive the same thorough examination as an adult. It is our belief that good dental experiences in youth will result in a positive dental attitude throughout life.

Some parents may desire to remain in the treatment room with the child. A parent’s presence can sometimes be comforting and reassuring for a child in a new situation. However, after one or two visits, we prefer to have the parent remain in the reception room. When present in the treatment room, it is important that the parent remain “in the background as a silent partner”. The doctor must be able to establish a good, direct relationship with the young patient. If the child’s attention is divided between several adults, it becomes difficult to not only get their attention but also to gain their confidence.

Parents play an important role in getting children started with a positive dental attitude. At home, please no use the words such as “hurt or pain” in saying things such as the “The doctor will not hurt you”. Fear of the dentist is often learned by the child from brothers, sisters, friends and adults. Be positive in your manner. Tell the child “the doctor is going to take pictures of your teeth, count your teeth and look at your teeth”. This is exactly what we are going to do. Above all, please do not use a visit to the dentist as a threat or punishment for misbehavior.


Sealants are generally placed on your adult molar teeth starting at about age six. When the first set of permanent molars develop, sealing these chewing surfaces will help keep them healthy and protect them from tooth decay. As other adult molars and pre-molars erupt, these too should be sealed. These "back teeth" usually have a rough surface with many grooves and pits in them. It is these grooves and pits which collect food leading to decay and cavities, even in a patient with excellent brushing habits. The sealant fills these grooves and pits so that food slides off the surface of the tooth lessening the chances for decay. The sooner these chewing surfaces can be sealed, the better it is for their long term protection. Adults with high decay rates may also benefit from this treatment. Consult with your dentist to determine whether tooth sealants are right for you.

NY Times Article: "Defending Your Children’s Teeth (and Dentists): The Value of Sealants"


Invisalign® is a new orthodontic treatment system that works to straighten teeth through the use of a series of clear plastic molds also known as aligners. These invisible braces eliminate the metallic smile that is characteristic of traditional orthodontic braces. Dr Zegarelli has earned the status of Invisalign Preferred Provider (for more on preferred providers, click here).

Invisalign®is a gentle push system for straightening teeth. The proper alignment of your teeth create not only a nicer look but also a healthier environment for your teeth and gums. Proper spacing of your teeth is good for the bone between your teeth and allows you to better clean your teeth. Visit for more inormation.

Tooth-Colored Fillings

Tooth-colored fillings are similar in color and texture to natural teeth. They are less noticeable and much more attractive than other types of fillings. Tooth-colored fillings are made from durable plastics called composite resins. You can smile, talk, and eat with confidence. Also, tooth-colored fillings are compatible with dental sealants. This allows a tooth to be filled and sealed at the same time to prevent further decay. These fillings do however have in some patients a higher degree of post-operative sensitivity issues.

Cosmetic Dentistry/Veneers

Cosmetic dentistry focuses on improving the appearance of a person’s teeth, mouth and smile. Cosmetic dentistry provides elective treatments and services such as composite bonding, teeth whitening, dental veneers and several other appearance enhancing options.

Dental veneers are custom designed ceramic-like material that is applied over the surface of a tooth. Veneers are used to cover worn tooth enamel, straighten uneven teeth alignment or spacing as well as repair chips or cracks. Dental veneers fall into the category of cosmetic dentistry because they create a bright, white smile with beautifully aligned, shapely teeth. The translucent ceramic of the veneers provide a more natural look.

Teeth Whitening

Teeth whitening is used to help lighten teeth, remove stains and also discoloration. Whitening is one of the most popular cosmetic dental procedures today. It can significantly improve how your teeth look. Whitening is not a one-time solution. It is a repeated process that you will have to do from time to time if you want to maintain a brighter and whiter smile.

Root Canal Therapy

Root Canal Therapy is performed when the nerve of the tooth becomes infected. Sometimes the patient presents with a pounding tooth ache and is in a great pain especially to hot and/or cold and biting. Other times the patient may wake up with a swollen jaw and in pain. In the first case, the nerve is alive but swollen and in the second case the nerve is diseased and abscessed with pus and facial swelling. In both instances root canal therapy is performed to remove the swollen or dead nerve from inside the tooth. Root canal is not removing the root of the tooth; it is removing the diseased nerve from inside the root of the tooth. Inside every tooth there is the nerve which is called the pulp. The pulp runs like a thread through the root and provides the nerves, blood vessels and nutrients for your tooth. When the pulp of the tooth is diseased or injured, the tissue dies. Root Canal is the process using miniature files to clean out that infection from inside your tooth. The only alternative to root canal therapy is an extraction of the tooth. In most cases after root canal a crown is placed onto the tooth to keep it from fracturing.

Most of the time, a root canal is a relatively simple procedure with little to no discomfort. A root canal can take as little as one or as many as three visits to complete. This is a very crucial procedure to help keep your teeth looking and feeling healthy.

Crowns & Bridges

A dental crown is a tooth-shaped “cap” that is usually placed over a single damaged, broken down or cracked tooth. It is routinely placed on teeth that have had root canal therapy. Crowns are used to restore the tooth to its proper shape and size. Sometimes, before a crown is placed the remaining tooth is so broken down that a crown buildup is needed in order to allow the proper shaping of the tooth for the crown. Other times as with root canal teeth, a post and core is needed again to allow for the proper shaping of the tooth. Once a crown is cemented into place the crown will fully encase the entire visible portion of a tooth that lies at the gum line. Crowns are made in many different materials such as gold, porcelain-fused-to-metal, ceramic or zirconium. Crowns are also used to cover a dental implant.

Dental bridges are multiple crowns that are connected together usually to replace missing teeth. Most typically, a bridge would be placed when one is missing a single tooth and there is minimally one tooth to either side of the missing tooth. In this case, connected crowns are placed on the teeth to either side of the space with a fake tooth in the middle.

Oral Surgery

A tooth extraction is a routine procedure used to treat diseased teeth. Teeth may need to be removed because of extensive decay rendering the tooth not restorable or because of gum disease with extensive bone loss or for other reasons. Every effort will be made to save a tooth but sometimes the removal of a tooth is the treatment of choice. Other oral surgery procedures are biopsies and other soft tissue procedures. See Post-Op Instructions for what to do after a surgical procedure.

Your dentist may remove a tooth if it is coming in at an angle, threatening the position of other healthy teeth or contributing to overcrowding in the mouth. Some other examples are a broken tooth that may also need to be removed, as well as teeth with significant tooth decay that cannot be treated by a root canal. Patients with advanced gum disease may be considered for an extraction as well.

While it is your dentist’s goal to do everything they can to save your teeth, in the end, removing a potentially harmful tooth can spare you time, money and discomfort.

Dental Implants

Implants are artificial tooth replacements made of titanium used to replace one or more missing teeth. The implant fixture, as it is known, is a titanium cylinder with a screw hole on the top that is placed by a surgeon into your jaw bone. The implant fixture is analogous to the root of your tooth. Dr. Zegarelli would screw the implant abutment onto the implant fixture. A crown on top of that finishes the procedure. Implants are used to avoid placing partial dentures or drilling virgin teeth in order to place a bridge.

Full and Partial Dentures

Dentures are replacements for missing teeth that can be inserted and removed from your mouth by you. They are removable and not cemented onto your teeth. Dentures are custom made in a dental laboratory from impressions taken of your mouth by your dentist with several fitting appointments. There are two types of dentures; full dentures and partial dentures.

Partial dentures are used when the patient has enough teeth to support some missing teeth. The partial denture clasps or grabs the remaining natural teeth which in turn support the missing denture teeth.

Full dentures are placed when the patient has no teeth. A full denture is a prosthetic devise. It does not replace your teeth. A full denture treats the condition of no teeth. There is a distinction here. When you lose your teeth, you not only lose the teeth but also the bone around the teeth and some of the gums. A full denture is a devise working to replace all these structures. An immediate full denture is placed when the patient has some teeth in their mouth which need to be all removed. With an immediate, the day the remaining teeth are removed is the day the full denture is inserted.

Oil Pulling

To see how Dr. Zegarelli feels about Oil Pulling, read this article.