General dentistry in Sunnyvale, CA with Dr. Shamiram Melko

Comprehensive dentistry including checkups & cleanings

We now offer CEREC® same-day crowns. These highly durable crowns are milled in the office the same day that your tooth is prepared for the crown and seated permanently on your tooth, all in one visit! CEREC® crowns offer many advantages, including saving you time as it requires only one appointment. We create your custom crown right here in our office using a digital 3D scan of your tooth. The new crown is fabricated using precise technology resulting in a crown that will entirely seal and protect your tooth for the long term. CEREC® crowns last on average 10-15 years, but when cared for correctly, they can last much longer. CEREC® same-day crowns can be fabricated from a variety of highly aesthetic, durable ceramic materials such as E-Max and Zirconia. Connect with us today to learn more!

Tooth-colored fillings

The most common condition treated within the scope of general dentistry is the treatment of dental caries or cavities. A cavity is caused by the invasion of bacteria in the solid tooth structure and the resulting demineralization of the tissue to a softer texture, leading to decay. The decayed area must be removed and replaced with a filling to protect the tooth from further deterioration. We use a composite (tooth-colored filling) made of synthetic resins for the filling material and it is cured, or hardened with a special light. The color of the filling matches the color of your natural tooth.

Root canals

Root canal treatment is simply treating an infection in the root canal of the tooth. When dental decay is not treated early enough, the bacteria may travel deep through the tooth to the pulp, which is the part of the tooth that houses the nerve and blood supply of the tooth. When the nerve and blood supply become infected in this way, the entire inner nerve and blood supply must be completely removed, and the space disinfected and filled. The filling is made from plant-based material and is compatible with natural oral tissue, and is very durable. The hard structure of the tooth is saved, and a crown is then placed to protect the remaining tooth.

A root canal may also be necessary if a tooth suffers direct external trauma that causes the enamel and dentin (which is just beneath the enamel) to crack. This causes the tooth to become vulnerable to infection inside the pulp. Another reason for a root canal to be performed is when chronic gum disease is not treated in a timely manner and the bacteria which originates in the gum tissue travels to the pulp chamber of the tooth, infecting the nerve and blood supply. If an infected tooth root and pulp are not treated in this way, the infection will worsen and result in a severe toothache. Once the infection has reached the inner nerve and blood supply, it is irreversibly damaged.

Root canal treatment in our office is completed in a careful and gentle manner, utilizing modern methods to anesthetize the tooth and make the patient as comfortable as possible. The crown which is placed to protect the remaining tooth is closely matched to the natural color and translucency of your tooth.

Extractions

When a tooth is so severely decayed that it cannot be saved or restored, the only option is to have it removed in order to eliminate the infection from the mouth. Removal of teeth can be accomplished either by routine dental extraction or by using more involved surgical extraction techniques, as is necessary when the tooth is severely damaged. Dr. Melko has years of experience performing both routine and more complex teeth extractions.

More complex extractions generally require reflecting a gum flap, sectioning the tooth into two or three parts, and removing them individually. She then augments (restores) the boney site of the extraction with bone grafts to prevent severe jawbone and contour loss in the area and to allow for a tooth replacement after healing. If a bone graft is not used, the bone height, width, and contour in the area of the missing tooth collapses and makes the placement of a dental implant difficult and much more costly. Bone grafts may be done in one of the following ways: allograft, alloplast, or autograft. Allograft is a laboratory-processed bone material from a tissue bank. Alloplast is synthetic bone. An autograft is performed by using bone tissue from the patient’s own bone. Dr. Melko has years of experience in choosing and placing the correct type and source of bone depending on the individual circumstances of each case.

Wisdom teeth

Wisdom teeth are the last set of teeth that erupt in the mouth, usually during the late teen years or early twenties. In many cases, these teeth will need to be removed due to a lack of sufficient room in the jaw (upper or lower) to allow them to emerge fully through the gums to the level of adjacent teeth. When there is insufficient room for the wisdom teeth, it causes crowding with the adjacent teeth which lead to decay of the roots and gum disease. In some cases, the insufficient room in the jaw leads to an impacted wisdom tooth or a tooth that is packed tightly against the bone and cannot emerge. This condition will almost always cause issues with the adjacent teeth, and the ensuing decay and/or gum disease could result in the loss of the adjacent tooth.
When wisdom teeth are removed, special surgical techniques are sometimes necessary, such as reflecting a gum flap and removing the bone covering the tooth before removing the tooth itself, most likely in two or three individual parts. If the wisdom tooth is only partially impacted in the bone or not impacted in the bone at all, the process of removing it is less complicated. Even if the wisdom teeth are only partially impacted under the gum, in many cases they still need to be removed due to spacing concerns and swelling around the gums (pericoronitis) that leads to pain and food traps, causing severe infection.

Emergency dentistry

At Melko Dental, we have seen and treated all types of dental emergencies. If you suffer a broken tooth, trauma to the mouth, pain, or swelling, please call us immediately and we will work to accommodate you the same day. If any of the following emergency situations occur, please take the steps outlined here as you are making plans to visit the office.

• Broken Tooth: If a tooth is broken due to a hard fall, direct blow to the tooth or while playing sports, apply ice to reduce pain and swelling. The pain may be especially severe if the fracture has exposed the nerve in the pulp of the tooth. Call us as soon as it happens!
• Avulsed Tooth: Sometimes the trauma is so intense that it might cause the tooth to be knocked out of, or avulsed from, its socket. When this happens, the patient is usually in extreme panic, which is understandable. It is imperative to call us as soon as you have rinsed your mouth with water and used clean gauze to stop the bleeding. If you have the tooth, place it in a container of milk and bring it with you when you visit our office. There is a possibility that Dr. Melko will be able to replace the tooth. Do not try to do it on your own as that might lead to complications.
• Soft Tissue Injury: When there is an injury to the lips, cheeks, mucosa of the mouth, tongue, or any other soft structure in and surrounding the mouth, it is important to see us as soon as possible. With these types of injuries, it is imperative to have the area screened, cleaned, and stitched, if necessary, to control bleeding and pain and receive any medications needed to accelerate healing. We are here to help!