We are now open!

Greetings to all of our patients!  

I want to take this time to reach out to you all and reconnect so as to let you all know what we've been up to during the Novel Corona Virus Pandemic.  I want to state that our #1 priority is, and has always been the health & safety of our patients, and, of course, to provide to you the highest quality dental care we can!  

I am sure most of you have questions and concerns regarding the safety of dentistry during this time, so we'd like to share the measures and actions we are taking to ensure your safety here at our office.

First of all, the culture here will be a little bit different in the “post novel corona virus world”.  At least until researchers come up with therapies and /or a vaccine!  We will be implementing some new systems in our practice to mitigate the risk of disease transmission here.  

What to expect when you come to the office?  Prior to your appointment, when Diana calls you to confirm your appointment date and time, she will ask a few quick questions regarding your medical status, and any symptoms suggestive of an illness...We ask that if you are ill with a fever, coughing, etc. to please reschedule for when you are well.  

We ask that you please call when you arrive to the office. Diana, Chelsea or Susie will meet you at your car to take a quick, touch-less temperature scan of the forehead, also you will have a small device clipped to your finger called an oximeter. This gadget shines light through your fingertip or earlobe. It works out how much oxygen is in your blood. We will then escort you directly to your treatment room.  

We will be spacing out our patient appointments so that there is only one patient on the dentistry side with Susie and I, and only one patient in the hygiene side with Chelsea.  For the most part, no one is allowed to wait in the lobby until further notice...We will of course, accommodate people escorting children or elderly patients.

All surfaces will be disinfected with Hospital Grade Disinfectants (as we've always done in the past) between patients.  All door knobs, light switches, etc. will be disinfected every 30 minutes throughout the day!  This will mitigate the risk of any infectious disease transmission via surfaces.

Ever since the HIV epidemic in the 1980's, dentistry as an industry has employed “Universal Precautions” (masks, gloves, “single use” disposable equipment, etc.) to mitigate disease transmission.  

The most concerning of transmission routes for infection, including novel corona virus, is via “'aerosols”.  Dentists and hygienists  have used “High Volume Evacuation” (HVE) routinely for decades to capture aerosols generated by dental hand pieces (drill) and ultra-sonic scaling devices.  HVE reduces aerosols by 90% !  

We will continue to use HVE for all procedures that generate aerosols.  In addition to HVE, we've invested in Medical Grade H-13 HEPA aerosol scavengers in our operatories (basically a very powerful vacuum) with a snorkel hose that we can position adjacent to the treatment field to scavenge any aerosol the HVE misses.

We have also invested in nine medical grade H-13 HEPA air filtration units placed throughout the office which will completely clean/turn over the air every 10 minutes, or six times per hour.

Another investment made was having medical grade UVC (Ultra-Violet C) units installed in our Central  Air Conditioning/Heating units that kill Bacteria and Virus as the air passes through. 

Finally, we will fog the office with Hypochlorous Acid, a human safe, yet powerful disinfectant at the end of each day.

We want you all to know that we are taking all possible precautions and measures to ensure your safety, and the safety of our team here!

To further streamline your experience at the office, we will be scheduling return visits for you in the operatory, at the end of your appointment.  We will make available electronic payment options in order to minimize visiting the front desk.

Warm regards,

Dr. Paulerio and Team

Socket Preservation

Socket preservation, also known as alveolar ridge preservation, is a common dental procedure designed to preserve the empty space left following an extraction. After a tooth has been removed, the bone that supported the tooth will eventually resorb, or deteriorate. In pronounced cases, this can lead to further tooth loss and visible changes in the cheeks and lips that result in a prematurely aged appearance. The empty space can also cause surrounding teeth to shift out of alignment. Shifting teeth compromise a balanced bite, which can result in the development of temporomandibular joint (TMJ) disorder, teeth grinding, and enamel erosion, fractures, or breakage. The main purposes of socket preservation are to minimize the potential for shifting teeth and to preserve the integrity of the bone tissue for future dental implant placement.

Who Should Undergo Socket Preservation?

Anyone who has a permanent tooth extracted should consider socket preservation. The procedure can preserve healthy bone density and quality, as well as proper dental occlusion. If the patient undergoes dental implant surgery in the future, prerequisite bone grafting will likely not be necessary. Patients who choose a traditional restoration can also benefit. Retaining proper bone mass in the jaw can ensure proper dental function and health, as well as a more youthful appearance.

tooth socket
Socket preservation can protect the health of your jaw and your entire smile following the extraction of a permanent tooth.

Techniques and Procedures

Several techniques and types of grafts can be used during the socket preservation procedure.  To begin, a dentist or specialist will administer local anesthesia. When the procedure is performed in conjunction with an extraction, the area will already be numbed. Once the socket is exposed and cleaned, a membrane will be inserted to isolate the treatment area. This will prevent surrounding tissue from adhering to the site and generating new gum tissue. The barrier also prevents bacteria from spreading to the area, which could cause infection. The membrane may be derived from animal sources, which is then used to make collagen, or it may be made of a synthetic material.

Socket preservation can prevent shifting teeth and further tooth loss, and preserve the integrity of the bone tissue for future dental implant placement. 

Following placement of the membrane, the dentist will insert a bone graft into the socket. There are many graft types, including:

  • Autograft: Bone from the patient’s own body
  • Xenograft: Bone from an animal source
  • Allograft: Donor bone
  • Alloplast: A synthetic material that resembles bone, such as tricalcium phosphate

Lastly, the graft is covered either directly by existing gum tissue, or with a resorbable membrane or protective material. Then the area is sutured closed.

bone grafting
Bone grafting can replace receded jawbone tissue in preparation for dental implants.

Aftercare and Preparing for Restoration

Immediately following tooth extraction and socket preservation, you should avoid brushing the surgical site for at least 24 hours. Cold packs can be applied to the cheek to minimize swelling in the area. You may be provided with prescription medication or advised to use over-the-counter anti-inflammatories to help manage any pain. Before leaving the office, you should receive detailed after-care instructions concerning foods to avoid and other tips.

Reducing the Risk of Dry Socket

After tooth extraction, a blood clot will form at the site which protects the nerve and promotes healing. If the clot becomes displaced by chewing, brushing, suction, or trauma of any kind, a dry socket can develop. To reduce the risk of dry socket, the patient should avoid smoking, drinking from a straw, drinking carbonated beverages, and swishing fluids around the mouth. Apart from a change in the appearance of the surgical site, dry socket can be accompanied by pain, bad breath, and an unpleasant taste in the mouth. If dry socket does occur, contact your dentist immediately.

Implant Placement

As the socket and jaw heal, new bone will regenerate and create a solid foundation for a dental implant. Generally, the dentist will allow at least four months for healing before placing a restoration. In rare instances, an implant may be placed at the same time the socket is preserved. Even a preserved socket will not last indefinitely. Without stimulation from dental roots or an implant, the bone will continue to atrophy. The dentist will usually place the restoration within 12 months of socket preservation for the best possible outcome. Once one or more implants have been placed, the area will typically need to heal for another four to six months before a permanent crown, bridge, or denture can be attached.

Protect and Restore Your Smile

Performed by a skilled dentist or oral surgeon, socket preservation is typically an effective procedure. Although your doctor will always try to save a natural tooth, in some cases, extraction is the best way to restore your oral health. Timely extraction, socket preservation, and implant placement can protect the health and appearance of your smile for years to come. 

Point Loma Family Dentistry team

Point Loma Family Dentistry

Dr. Louis E. Paulerio is a top-rated dentist who is committed to providing the latest dental treatments in a caring, warm setting. He is a member of several prestigious dental organizations, including: 

  • Academy of General Dentistry
  • International Dental Implant Association

He also uses CEREC technology to create beautiful, long-lasting dental restorations in just one appointment. Ready to schedule a consultation at our Point Loma office? Request your appointment online or call us at (619) 223-3811.

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1635 Rosecrans St
Ste A
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