A). Bleaching of the teeth.
Our home bleaching requires only 5-30 minutes of bleaching per day. Not everyone is a candidate for bleaching. Over time our teeth tend to become discolored or stained. Whether this is from smoking, coffee, or any other foods, a beautiful smile could be closer than you think. We offer a safe, inexpensive solution to an unsightly smile. Whitening your teeth is a very simple procedure that can be completed in relatively short period of time. Most people have either white, gray or yellow teeth—or any combination of these 3 colors. Bleaching works best when removing yellow from the teeth. Gray colors are very difficult to bleach. Please call our office for a free consultation to see if your teeth can be improved with bleaching.
B). Cosmetic dentistry
There are many ways to improve the smile of an individual. If the front teeth are crooked or spaces, braces and all porcelain crowns will enhance the esthetics. Sometimes, we can make the crooked and spaced front teeth look beautiful without using braces. We also offer porcelain veneers. There are small pieces of porcelain that are bonded over the front sides of teeth. The patients’ teeth need to be sound and in good position before veneers are placed. All bonded porcelain crowns are used when the teeth are not sound (contain fractures or large fillings).Veneers: A porcelain veneer is an extremely thin porcelain facing (about the size of a finger nail) which is bonded to the front of a tooth. Porcelain veneers are placed over the front of teeth that appear too small or large, slightly discolored, or simply are not cosmetically pleasing to the patient. For many patients, teeth may have chipped, become discolored, or are slightly crooked. For the majority of these patients, porcelain veneers can prove to be the perfect solution.
When placing porcelain veneers, we pay close attention to the patient’s surrounding teeth and design each veneer to compliment the overall smile. The result is a beautiful, attractive new smile. If cared for properly, your veneers will last you a long time. We ensure that your new veneers are constructed of the most durable porcelain materials
We use tooth-colored fillings (cosmetic fillings) on all front teeth, which are fillings made of composite resin material called Dyract by Dentsply and Ultrabond by Denmat Corporation We bond cosmetic fillings which make them stronger and less likely to leak. Sometimes we are able to close gaps between front teeth with these bonded tooth-colored cosmetic fillings.
Tooth-colored fillings (cosmetic fillings) in the back teeth require a higher fee because these back teeth cosmetic fillings require more time and expense to place. We use Filtek low shrinkage composite resin filling material for all cosmetic fillings in the back teeth. Each cosmetic filling in the back teeth requires extra insulation layers and at least seven to nine curing procedures as compared to about five curing procedures for a front tooth cosmetic filling. Most dental insurance companies do not allow for the higher fee for a back tooth cosmetic filling. Silver fillings in the back teeth have a lower fee than back teeth cosmetic fillings. Most insurance companies will only allow the amount for the fee of a silver back tooth filling to be applied towards the higher fee for the cosmetic back tooth filling. if a patient decides to get a back tooth cosmetic filling instead of a back tooth siver filling. The patient will pay the difference between the higher fee for the back tooth cosmetic filling and the lower insurance allowable fee for a back tooth silver filling of the same size.
Cosmetic fillings for the back teeth may have to be adjusted the day after they are placed. When patients have their mouths numbed up while the cosmetic fillings are placed, many times patients bite differently while they are numb. After the numbness wears off, patients may experience hitting first on the cosmetic back teeth fillings, which can cause sensitivity, especially cold sensitivity. If this happens, patients should call the office and come in to have the cosmetic back teeth fillings adjusted.
D). Silver fillings.
Silver fillings for the back teeth are still the standard of care. The American Dental Association still recommends them as being safe and the most durable of all back teeth fillings. For our concerned patients, we have a pamphlet in our office, printed by the American Dental Association, explaining the safety and reliability of silver fillings in the back teeth.
We bond all our silver fillings. The bonding makes the silver fillings stronger and less likely to leak over a period of time. Bonding also decreases the cold sensitivity that may be a result of having metal silver fillings placed. If silver fillings are placed and remain cold sensitive after the first few days, the dentist should be informed. Many times it is just a matter of adjusting the fillings because the opposing teeth are hitting too hard on the silver fillings while eating. Upon request by the patient, we will place back teeth cosmetic fillings instead of silver fillings in the back teeth, as explained aboce in section C.
E). Crowns and Bridges
Crowns: We place various crowns on teeth that are not able to be filled or that have had root canal treatment. A tooth that has had a root canal treatment tends to dry out and becomes brittle over a period of years. Crowning, or covering the entire tooth, will protect the root-canal filled tooth from any future fracture. All crowned teeth must be brushed and flossed as any other teeth. Without proper cleaning, cavities may occur around and up under the crowned tooth. We place full porcelain bonded crowns, porcelain fused to zirconium crowns (these crowns are computer made, very beautiful and strong), full zirconium crowns (computer made crowns that are tooth colored and are as hard as full metal crowns), porcelain fused to high noble metal crowns, porcelain fused to noble metal crowns, CAPTEK crowns (very thin high luster gold under the porcelain), gold crowns and platinum/palladium silver colored crowns.
We do not routinely use non-precious metal in any of the crowns that we fabricate because the nickel content in the non-precious metal crowns may cause many patients to have allergic reactions in the gum area surrounding the non-precious metal. Bridges: We place several types of fixed, non-removable bridges. A bridge is a dental appliance used as a means to replace a missing tooth or teeth by crowning the teeth on each side of the missing tooth or teeth and attaching the false replacement tooth or teeth to the crowns on each side of the missing tooth or teeth.
F). Removable partial dentures.
We offer several types of removable partial dentures to replace missing teeth when the patient still has some or many teeth, but does not have all of the teeth. The standard removable partial denture is made of a metal base with plastic teeth and plastic gums attached to the metal base. Usually retentive wires will show when the patient smiles while wearing this standard removable partial denture.
A relatively newer removable partial denture is the “VALPLAST” (www.valplast.com) removable partial denture. This removable partial denture is made from plastic and nylon. There is no metal in this Valplast partial denture and many patients have told me how much they like a metal-less removable partial denture. Removable partial dentures should not be worn while sleeping because the tissues are damaged by not having a rest; problems from bad breath to oral cancer can occur (cancer being very rarely caused by the irritation of a removable partial denture or a removable full denture, which replaces all of the missing teeth)
G). Full dentures.
Full dentures are required when all the teeth are missing. If a patient has good lower natural teeth and no upper teeth, then the patient may get just the upper full denture and keep the lower natural teeth. Patients do much better with the upper full denture than the lower full denture. It is alright to have an upper full denture and have lower natural teeth. A lower full denture does not work when biting against upper natural teeth, because the lower gums bruise too easily. The lower smaller ridge makes the lower full denture very difficult to wear for many patients. It is always best to avoid the lower full denture and opt for a lower removable partial denture instead. Even by saving just two lower teeth, a patient may avoid the full lower denture and will be able to wear a lower removable partial denture much better than a full lower denture. Not every patient can wear a lower full denture. Certain conditions, as a small narrow lower ridge that supports the lower full denture and health problems as Diabetes, make it impossible to wear a lower full denture. Diabetes causes easy bruising and much difficulty in wearing a lower full denture.
Denture adhesive powders and pastes may be very helpful. “SEA BOND” is a name brand of denture adhesive that is helpful under the lower full denture. A patient with a small lower ridge and difficulty in wearing a lower denture should have a lower soft reline material placed into the lower denture. The lower soft reline material and the use of a SEABOND adhesive makes the lower denture easier to wear. Dental implants are used to “snap” the lower denture into place. Dental Implants are explained below in section” I”.
H). Relines of Full dentures and removable partial dentures
Full dentures and removable partial dentures need to periodically be relined (refitted). This is because over a period of time, the ridge under the full dentures and removable partial dentures will resorb (shrink away). There are two types of denture reline procedures.
1). In office reline whereby the reline material is placed in the denture and then molded to the tissues in the mouth and cures (gets hard) in the mouth. This reline has a lesser fee than the next reline:
2) Laboratory fabricated reline. This type of denture reline is better than the in-office reline because the reline material is cured under pressure and heat for a period of approximately 8 hours. This means that there is less porosity in the reline material. Porosity in the reline material leaves areas for bacteria to lodge and cause denture bad breath. This procedure requires an impression and usually keeping the denture overnight. In certain cases, the impression may be made at 8:00 am and the reline completed by 4:30 pm., the same day.
There are three types of reline material used:
1) A temporary soft liner that may be used in certain cases.
2) A laboratory soft liner that is usually placed in the lower denture
3) A hard liner (as explained done either in office or in the laboratory over night).
Dental Implants are small metal cylinders that are placed into the jawbone where there are no teeth. A single dental implant may have a false tooth attached to it. Dental implants may also be used to support many false teeth. Dental implants many also be used to support a full denture whereby the full denture snaps into place and does not move during eating or talking. The specialist surgically places the implants and I add any teeth to the dental implants (whether single crowns, fixed bridges, removable partial dentures, or removable full dentures). The success rate for dental implants is amazing.If a patient is interested in dental implants, the patient is evaluated by me and then I refer the patient to a surgical specialist, who consults with the patient, explains the implant(s) and surgery fees. Then the patient comes back to me for a second consultation when I will explain my treatment and fees once I know the type, number and positions of dental implants that the patient and surgery specialist agreed upon. After consulting with me this second time, and then the patient understands the specialist’s treatment plan and fees, and my treatment plan and fees. The procedures begin once the patient understands the entire treatment and the fees involved.After dental implants are placed, there is an approximate 8-12 week healing time before I begin restorations. The patient usually wears some type of temporary replacements in the meantime. In certain situations, a tooth may be extracted and the implant placed immediately.
J). Root Canal treatment
A root canal procedure is a dental procedure done to save a tooth that is infected by tooth decay, or to save a dead tooth that has died over a period of time after previous dental treatments (as deep fillings or crowns) or injury (cracked teeth). If there is sufficient tooth structure left to restore, it is often practical to save the tooth instead of extracting the tooth.
Procedure: The inside infected or dead tissue is removed from the roots of the tooth and replaced with a soft filling material. Root canals work some 90% of the time. There is approximately a 10 % national failure rate when doing root canal procedures. Every patient who has a root canal procedure must agree to accept the possibility that the root canal treatment may be unsuccessful. I use one of the most popular and successful root canal systems called “Thermafill by Dentsply”. Most root canal fillings are done in one appointment. However, some root canal treatments may take several appointments. I sometimes refer a patient to a root canal specialist (Endodontist). Some root canals are too small to gain access and a root canal specialist has a special microscope that may be used to access these small canals.
K). Bone and gum problems (periodontics)
Gum and bone disease (periodontitis) is the most common disease known to mankind. It is caused by plaque (sticky germs sticking to the teeth) being calcified by the calcium in the saliva and forming a hard substance called calculus or tartar on the teeth and teeth roots. As the calculus builds up, it migrates down the roots of the teeth destroying gums and bone as it migrates down the roots. The acid produced by the plaque also damages gum and bone and causes tooth decay. More teeth are lost because of periodontal disease than due to tooth decay. If we catch the periodontal disease in its earlier stages, it is cured by cleaning the teeth and roots of the teeth. A regular cleaning will cure the disease in its most early stage. If the periodontal disease is more advanced, the teeth are usually deep cleaned with an ultra-sonic tooth cleaning instrument while the teeth are numbed up. This is called deep cleaning and scaling. If the disease is too advanced, deep cleaning and then surgery may be indicated and/or referral to a gum and bone disease specialist, a periodontist.
L). Oral Surgery.
Our office performs various types of oral surgery-––the most common surgery is tooth extraction. We also reshape bone so a patient will be able to wear dentures. We also perform basic periodontal surgery (surgery of the gum and bone to cure any disease around the teeth).
We have had extensive experience in treating TMJ Problems. The joint in front of the ear is called the Temporo-mandibular joint because the joint is where the side of the head bone (the temporalis bone) and the lower jaw (mandible) meet. If there is noise as clicking noises in the joint, this means that the cartilaginous disc between the temporalis bone and the mandible is coming out of place. When the disc in the joint pops in and out of place, the muscles associated with the joint go into spasm causing headaches and neck aches. The first and most essential treatment for this joint problem is to make a bite plane appliance. This bite plane appliance is a plastic appliance that is worn usually over the teeth of the upper jaw. When the lower teeth strike the upper bite plane appliance, healing and symmetry is induced into the disordered joint. Usually the headaches and neck aches will stop. The patient wears the bite plane as little as possible in order to stay comfortable, usually while sleeping. If the joint is damaged too much, then a referral to Dr. Ken Farha in Montgomery is required. Dr. Farha has had more experience treating TMJ disorders than any professional that I know. His full time dental practice is dedicated to treating TMJ disorders. Dental insurance does not cover the fee for a bite plane appliance. However, we have been very successful in recovering much of the cost from the patient’s medical insurance.
N). Preventive Dentistry
Examination and Cleaning of the teeth (Prophylaxis).The most important aspect of dentistry is “Preventive Dentistry”. This aspect of dentistry is geared towards preventing any dental disease by us dentists and dental hygienists teaching the patients the causes of dental diseases and giving proper instructions on how to floss properly and brush properly. Routine cleanings and proper home care prevent the possibility of dental disease from ever starting. Our experienced hygienists enjoy cleaning teeth and teaching patients what they need to know in order to maintain a healthy oral environment. Other aspects of Preventive Dentistry involve x-rays ( we use state of the art digital x-rays) to detect certain oral diseases and unhealthy conditions, pit and fissure sealants to prevent cavities in cavity-prone teeth, and fluoride treatments to help harden cavity-prone teeth.