Frequently Asked Questions (FAQ)

Localized collection of pus in a cavity in the deeper layers of the skin or within the body, formed from tissues broken down by white blood cells (leukocytes) in response to inflammation caused by bacteria.  A wall develops, separating the thick yellowish pus from the extracellular fluid of nearby healthy tissues.  Rupture of the abscess allows the pus to escape and relieves swelling and pain.  Treatment consists of cutting into the wall to drain the pus and giving antibiotics.  If infective contents enter the bloodstream, they may be carried to remote tissues, seeding new abscesses.

Your dentist already confirmed that you do have symptoms.  Pain is not a reliable indicator of anything.  Just ask anyone with severe gum disease and jawbone resorption.

It is possible to have an abscessed tooth without swelling or pain.  It sounds like something else is going on besides a bad tooth.  I suggest you get to your dentist and have dental problems figured out and then off to your doctor to find out the other cause of your pain.

See Implants All-on-4 Procedure - What is this procedure and when is it used?

See Fillings - Are Mercury Silver Amalgam fillings safe?

FEAR is just "Fantasizing Events Appearing Real", and anxiety is your reaction to these imagined events. To conquer this, what you need to do is have knowledge about what is to happen, and then take the experience in the moment it is happening, and not project yourself into an imaginary future. This is something that requires time and attention for you and the dentist, and will help you get healthy, and remain that way.

Fortunately, many dental procedures do not have to be uncomfortable. Our office uses new, more effective types of anesthetic to numb the teeth and gums than ever before. We have many alternatives designed to distract you from the dental procedure, and to help you with the psychological discomfort you may associate with visiting a dentist. Nitrous oxide gas, anti anxiety medication (when appropriate), sedation anesthesia (when appropriate), along with a heavy dose of good old fashioned "TLC", will get the biggest "fraidy cat" to relax through several hours of treatment.

To further ease dental anxiety, we have created a soothing, peaceful atmosphere that is warm, friendly and relaxing. Unlike the typical sterile feel and smell of most dental offices, our practice has created an ambiance reminiscent of a day spa in an upscale resort. The reception area is accented with comfortable furnishings, large aquarium, massage chair, aquamassage, and a refreshment center with coffee, tea and oxygenated water. Once seated in the treatment room, you will enjoy a complete spectrum of relaxing comforts and spa-like amenities. You will be pampered with a warm neck pillow, cozy blanket and warm paraffin wax hand treatments. You can escape to your favorite news channel or movie on a flat screen TV.

All this tends to relax patieints anticipating and during a dental visit. The bottom line, we not only want you to love your new smile, but to enjoy the process. Our entire team wants to make sure you're comfortable at all times. Some patients have said they would rather linger at our dental spa than return to work. Click here for more information about how our dental spa reduces dental anxiety.

At age 22 your best option is to find a great orthodontist in your area for an examination. The primary tooth can be extracted and your adult tooth can be guided into place by the orthodontist. You may have a gap while your tooth is guided into place,but you will look so much better once this normal sized tooth is in it's correct place. The investment for this treatment can only be reviewed by the orthodontist. A visit to the orthodontist will give you all the information needed to make an informed choice on what you want to do.

See Full Mouth Restoration and Orthodontics

More than 90 Million people suffer from chronic halitosis or bad breath. Bad breath can be an unpleasant and embarrassing condition. Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning. There are various reasons one may have bad breath, but in healthy people, the major reason is due to microbial deposits on the tongue, especially the back of the tongue, and in the gums. Some studies have shown that simply brushing the tongue reduced bad breath by as much as 70 percent. Click here for detailed information and video.

Although there may be a number of causes, most of the time, halitosis originates in the mouth. It is caused by oral bacteria breaking down stubborn food debris and their decay. This process creates byproducts called volatile sulfur compounds, which emit a smell similar to rotten eggs. The type of bacteria that initiates this process needs an environment that is free of oxygen, so they usually inhabit areas that are difficult to reach, such as the pockets around teeth and the fissures of the tongue. In some circumstances, the odor may be caused by a systemic condition such as diabetes or a problem in the sinuses, pharynx, lungs, or stomach. Other debris in your mouth and poor oral hygiene can also cause odor.

Therefore, the first step in solving bad breath problems is to undergo a medical examination to ensure that there are not any medical conditions contributing to the condition. Following is a list of other factors that are all secondary to the main culprit - oral bacteria.

• Morning time – Saliva flow almost stops during sleep and its reduced cleansing action allows bacteria to grow, causing bad breath.
• Certain foods – Very spicy foods, such as onions and garlic, and coffee may be detected on a person's breath for up to 72 hours after digestion. Onions, for example, are absorbed by the stomach and the odor is then excreted through the lungs.
• Poor oral hygiene habits – Food particles remaining in the mouth promote bacterial growth.
• Periodontal (gum) disease – Colonies of bacteria and food debris residing under inflamed gums.
• Dental cavities and improperly fitted dental appliances – May also contribute to bad breath.
• Dry mouth (Xerostomia) – May be caused by certain medications, salivary gland problems, or continuous mouth breathing.
• Tobacco products – Dry the mouth, causing bad breath.
• Dieting – Certain chemicals called ketones are released in the breath as the body burns fat.
• Dehydration, hunger, and missed meals – Drinking water and chewing food increases saliva flow and washes bacteria away.
• Certain medical conditions and illnesses – Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath.

Cancer patients who undergo radiation therapy may experience dry mouth. Even stress, dieting, snoring, age and hormonal changes can have an effect on your breath. An odor that comes from the back of your tongue may indicate post-nasal drip. This is where the mucus secretion, which comes from the nose moves down your throat, gets stuck on the tongue and causes an odor. Bad breath originating in the stomach, however, is considered to be extremely rare.

Keeping a record of what you eat may help identify the cause of bad breath. Also, review your current medications, recent surgeries, or illnesses with your dentist. If you have concerns about bad breath, please discuss this with the doctor at your next visit. Click here for detailed information and video.

If it is clear that bacteria are the culprits, methods to reduce them are the first line of defense. That's why if you have bad breath, you should make sure to obtain a complete dental examination that includes a periodontal examination. Keeping your mouth as clean as possible, helps eliminate bacteria. In fact, it's valuable to consider this cleaning process as "full-mouth disinfection", focusing on all areas where bacteria may reside. This "disinfection" includes thorough brushing, proper use of dental floss, mouth rinse and cleaning the tongue. Remember, you're not alone. We are here to help.

It is also important to practice good oral hygiene such as brushing and flossing your teeth at least twice a day. To alleviate the odor, clean your tongue with your toothbrush or a tongue scraper, a plastic tool that scrapes away bacteria that builds on the tongue. Chewing sugar-free gum also may help control the odor. If you have dentures or a removable appliance, such as a retainer or mouth guard, clean the appliance thoroughly before placing it back in your mouth. Before you use mouth rinses, deodorizing sprays or tablets, talk with our dentist because these products only mask the odor temporarily, and some products work better than others.

• Practice good oral hygiene – Brush at least twice a day with an ADA approved non-fluoride toothpaste and toothbrush. Floss daily to remove food debris and plaque from in between the teeth and under the gumline. Brush or use a tongue scraper to clean the tongue and reach the back areas. Replace your toothbrush every 2 to 3 months. If you wear dentures or removable bridges, clean them thoroughly and place them back in your mouth in the morning.
• See your dentist regularly – Get a check-up and cleaning at least twice a year. If you have or have had periodontal disease, your dentist will recommend more frequent visits.
• Stop smoking/chewing tobacco – Ask your dentist what they recommend to help break the habit.
• Drink water frequently – Water will help keep your mouth moist and wash away bacteria.
• Use mouthwash/rinses – Some over-the-counter products only provide a temporary solution to mask unpleasant mouth odor. Ask your dentist about antiseptic rinses that not only alleviate bad breath, but also kill the germs that cause the problem. In most cases, your dentist can treat the cause of bad breath. If it is determined that your mouth is healthy, but bad breath is persistent, your dentist may refer you to your physician to determine the cause of the odor and an appropriate treatment plan. Click here for detailed information and video.

Saliva is the key ingredient in your mouth that helps keep the odor under control because it helps wash away food particles and bacteria, the primary cause of bad breath. When you sleep, however, salivary glands slow down the production of saliva allowing the bacteria to grow inside the mouth. To alleviate "morning mouth", brush your teeth and eat a morning meal. Morning mouth also is associated with hunger or fasting. Those who skip breakfast, beware because the odor may reappear even if you've brushed your teeth. Click here for detailed information and video.

The gums bleeding may be caused by many factors. You should be seen by a periodontist (gum dentist) and have a blood test done by your Medical Doctor. This would determine the cause of the problem. See Gum Disease

Since you did not mention that you have been flossing your teeth, the most probable reason your gums are infected and bleeding is that you are leaving a lot of plaque and bacteria between the teeth when you brush. Brushing your teeth, even with an expensive electric toothbrush, only removes about 70-75% of the plaque, bacteria and toxins that accumulate around your teeth every 24 hrs. The other 25-30% of the above mentioned "stuff" stays lodged between the teeth and under the gums. Here it continues to breakdown, irritate the gum tissue and cause inflammation and bleeding. It also causes foul odors and bad breath that cannot be masked by brushing, rinsing with a mouthwash or chewing dentine gum.

The sobering fact is that 73% of adults over the age of 30 have some stage of periodontal (gum) disease. The reason is that gum disease and bone loss occurs without any "PAIN" and minimal bleeding at first. As the periodontal toxins continue to silently eat the bone away from around the teeth, deep periodontal pockets develop which are even harder to clean out. A patient first starts to notice there is a problem once the gums start to bleed by just brushing the teeth, or they have persistant bad breath.

In your case, I would start by flossing your teeth at least once per day to reduce the bacteria between your teeth. If you do not have actual underlying bone loss and pocketing, you can expect your gums to bleed for about 5-7 days as you continue to floss once a day. Then after about a week, the bleeding will start to stop as your gums get pinker and healthier.

The next step is to make an appointment to have your teeth professionally cleaned and examined. During your cleaning appointment make sure to ask your dentist to do a periodontal probing of your gum pockets to rule out any beginning periodontal bone loss. See Gum Disease

Bonding is done by placing tooth-like material onto the tooth to both build and alter its shape. Because natural tooth structure is usually not removed, its best use is somewhat limited to broken or chipped teeth. The advantage of bonding is that it is a relatively inexpensive and conservative way to restore a tooth. One disadvantage is that over time, the bonded portion of a tooth may change color as compared to the natural, un-bonded portion of the tooth. Another disadvantage is that it is more prone to breakage. Click here for detailed information and video.

A porcelain veneer or crown on the other hand, will not discolor and will be far stronger in the long run. This may cost more, and the preparation of the affected tooth will be more extensive, but may be necessary in order to get a smooth, natural appearance. A veneer covers the front, sides, and biting surface of the tooth. Once properly "seated", it becomes your tooth. It should be seamless. They are very strong and durable and are no more likely to break than a real tooth. And like a real tooth, the veneer is repairable if it were ever to chip or break. See Veneers

Bone Grafting is often closely associated with dental restorations such as bridge work and dental implants. In the majority of cases, the success of a restoration procedure can hinge on the height, depth, and width of the jawbone at the implant site. When the jawbone has receded or sustained significant damage, the implant(s) cannot be supported on this unstable foundation and bone grafting is usually recommended for the ensuing restoration. There are several major factors that affect jaw bone volume:

• Periodontal Disease - Periodontal disease can affect and permanently damage the jaw bone that supports the teeth. Affected areas progressively worsen until the teeth become unstable.
• Tooth Extraction - Studies have shown that patients who have experienced a tooth extraction subsequently lose 40-60% of the bone surrounding the extraction site during the following three years. Loss of bone results in what is called a "bone defect".
• Injuries and Infections - Dental injuries and other physical injuries resulting from a blow to the jaw can cause the bone to recede. Infections can also cause the jaw bone to recede in a similar way.

Click here for detailed information and video.

Bone grafting is a highly successful procedure in most cases. It is also a preferable alternative to having missing teeth, diseased teeth, or tooth deformities. Bone grafting can increase the height or width of the jawbone and fill in voids and defects in the bone. There are essentially two basic ways in which bone grafting can positively impact the health and stability of the teeth:

• Jaw Stabilization - Bone grafting stabilizes and helps restore the jaw foundation for restorative or implant surgery. Deformities can also be corrected and the restructuring of the bone can provide added support.
• Preservation - Bone grafting can be used to limit or prevent bone recession following a tooth extraction, periodontal disease, or other invasive processes.

Oral Examination - Initially, the dentist will thoroughly examine the affected area in order to assess the general condition of the teeth and gums. If periodontal disease is present or the adjacent teeth are in poor condition, these factors will be fully addressed before the bone grafting procedure can begin. The dentist will also recommend panoramic x-rays in order to assess the precise depth and width of the existing bone. On occasion, a CAT scan may be recommended to determine the bone condition. Depending on these results, the dentist may also anesthetize the area and explore into the gum in order to determine what kind and how much bone is required.

Click here for detailed information and video.

There are several types of bone grafts. Your dentist will determine the best type for your particular condition.

• Autogenous Bone Graft - Harvested from the patient's own body (usually from the posterior part of the lower jaw or the chin). This method is usually preferred because it produces the most predictable results.
• Allograft Bone Graft - Cadaver or synthetic bone is used in this type of graft.
• Xenograft - Cow bone is used in this type of graft.

The bone grafting procedure can often take several months to complete. Bone is typically harvested from your own body (or on rare occasions obtained from a "bone bank") and added to the affected site. This bone will fuse with the existing bone and the migration of cells will cause firm adhesion and cell growth. Supplementing the jaw with bone will result in greater bone mass to help support and anchor the implant(s).

During the surgery, the dentist will numb the grafting and extraction sites using local anesthetic. A small incision will be made to prepare the site for the new bone and it will be anchored into place. On occasion, a synthetic membrane may be used to cover the new bone. This membrane prevents soft tissue and bacterial invasions, and encourages new bone growth. The surgery does not require an overnight stay, and you will be provided with comprehensive instructions for your post-operative care. The dentist will prescribe medications to help manage infection, discomfort and swelling.

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Periodontitis (periodontal disease) is a set of inflammatory diseases affecting the periodontium — that is, the tissues that surround and support the teeth. Periodontitis involves progressive loss of the alveolar bone around the teeth, and if left untreated, can lead to the loosening and subsequent loss of teeth. Periodontitis is caused by microorganisms that adhere to and grow on the tooth's surfaces, along with an overly aggressive immune response against these microorganisms. A diagnosis of periodontitis is established by inspecting the soft gum tissues around the teeth with a probe (i.e. a clinical exam) and by evaluating the patient's x-rays to determine the amount of bone loss around the teeth. Specialists in the treatment of periodontitis are periodontists; their field is known as "periodontology" or "periodontics".

Click here for detailed information and video.

See Orthodontics Braces vs. Veneers - What are the pros and cons of Braces vs. Veneers?

A dental bridge like the Golden Gate Bridge connects 2 islands. The pontic is the missing tooth over the water and the abutments are the islands. The two abutments are crowns which hold it in place and are attached onto your teeth on each side of the false tooth. Fixed bridges are used to replace one or more missing teeth and cannot be taken out of your mouth as you might do with removable partial dentures. Bridges can reduce your risk of gum disease, help correct some bite issues and even improve your speech. Bridges require your commitment to serious oral hygiene, but can last as many as ten years or more.

There are 3 types of dental bridges.

• Traditional Fixed Bridge - A dental bridge is a false tooth, known as a pontic, which is fused between two porcelain crowns to fill in the area left by a missing tooth. There are two crowns holding it in place that are attached onto your teeth on each side of the false tooth. This is known as a fixed bridge. This procedure is used to replace one or more missing teeth. Fixed bridges cannot be taken out of your mouth as you might do with removable, partial dentures.
• Resin Bonded Bridge - The resin bonded is primarily used for your front teeth. Less expensive, this bridge is best used when the abutment teeth are healthy and don't have large fillings. The false tooth is fused to metal bands that are bonded to the abutment teeth with a resin, which is hidden from view. This type of bridge reduces the amount of preparation on the adjacent teeth.
• Cantilever Bridge - In areas of your mouth that are under less stress, such as your front teeth, a cantilever bridge may be used. Cantilever bridges are used when there are teeth on only one side of the open space. This procedure involves anchoring that false tooth to one side over one or more natural and adjacent teeth.

Click here for detailed information and video.

• Advantages - Bridges are natural in appearance, and usually require only two visits to place. If you maintain good oral hygiene, your fixed bridge should last as many as ten years or more.
• Disadvantages - It is common for your teeth to be mildly sensitive to extreme temperatures for a few weeks after the treatment. The build up of bacteria formed from food acids can cause your teeth and gums to become infected if proper oral hygiene is not followed.

Click here for detailed information and video.

If you have one or more missing teeth, and have good oral hygiene practices, you should discuss this procedure with your cosmetic dentist. If spaces are left unfilled, they may cause the surrounding teeth to drift out of position. Additionally, spaces from missing teeth can cause your other teeth and your gums to become far more susceptible to tooth decay and gum disease. Click here for detailed information and video.

We prepare your teeth on either side of the space for the false tooth. You will be given a mild anesthetic to numb the area, and then remove an area from each abutment (teeth on either side of the space) to accommodate for the thickness of the crown. When these teeth already have fillings, part of the filing may be left in place to help as a foundation for the crown. We will then make an impression, which will serve as the model from which the bridge, false tooth and crowns will be made by your dental laboratory. A temporary bridge will be placed for you to wear while your bridge is being made until your next visit. This temporary bridge will serve to protect your teeth and gums. On your second appointment, the temporary bridge will be removed. Your new permanent bridge will be fitted, checked and adjusted for any bite discrepancies. Your new bridge will then be cemented to your teeth. Click here for detailed information and video.

Yes. If you are an appropriate candidate, a porcelain bridge can look as natural as your own teeth (or in many cases better), in color and shape, in proportion and alignment, without the appearance of any clasps or metal. Some bridges are designed with a metal support structure or a metal lining, covered with porcelain, called porcelain fused to metal (PFM). At one point in time, most restorations were made this way. When placed, they usually can often look opaque or "flat" because they do not let light pass through like a natural tooth. There can also be a tell-tail dark band showing through the teeth or showing next to the gum-line that is undesirable (often the darkness invades the adjacent gum tissue as an adverse reaction). All porcelain bridge restorations are what we prefer to use unless there is a compelling reason otherwise. Again, when properly seated, they are virtually as strong as, or stronger than, their metal predecessor. Click here for detailed information and video.

A less expensive (but less durable) option may be a bonding that can be applied, color-matched and shaped to make your tooth appear natural again. The long-term restoration of choice is crowns or porcelain veneers.

The brand of the toothbrush is not nearly as critical as the type of bristle, the size and shape of the head, and how frequently you replace your brush. We recommend a soft bristled brush with a small head. The soft bristles are most important for the health of your gums. A small head allows you to get around each tooth more completely and is less likely to injure your gums. Daily frequency of brushing and replacement with a new brush are much more important issues than the brand you choose.

Electric toothbrushes have become more popular for a variety of reasons. They do a good job of reducing stains, removing plaque, and disrupting the bacteria that cause tooth decay and gum disease. Electric toothbrushes can be easier to manage than a manual toothbrush, and they are fun to use. Click here for detailed information and video.

Brushing and flossing help control the plaque and bacteria that cause dental disease.

Plaque is a film of food debris, bacteria, and saliva that sticks to the teeth and gums.  The bacteria in plaque convert certain food particles into acids that cause tooth decay.  Also, if plaque is not removed, it turns into calculus (tartar).  If plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease. Plaque formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids.

Toothbrushing - Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.

• Brush at a 45 degree angle to the gums, gently using a small, circular motion, ensuring that you always feel the bristles on the gums.
• Brush the outer, inner, and biting surfaces of each tooth.
• Use the tip of the brush head to clean the inside front teeth.
• Brush your tongue to remove bacteria and freshen your breath.

The newer electric toothbrushes such as a Sonicare, Rotadent and Braun are highly recommended and more effective in removing plaque then a manual toothbrush. They are still not a substitute for flossing which eliminates the plaque from the surfaces between the teeth. They are easy to use and can remove plaque efficiently.  Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time. Click here for detailed information and video.

Flossing - Daily flossing is the best way to clean between the teeth and under the gumline.  Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth and bone.

• Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
• Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
• Curve the floss into a "C" shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss. Click here for detailed information and video.

Rinsing - It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush.  If you are using an over-the-counter product for rinsing, it's a good idea to consult with your dentist or dental hygienist on its appropriateness for you.

No. Although brushing thoroughly after each meal helps, flossing your teeth every day to remove plaque and food particles between teeth and the gum line is just as important. Studies show that plaque will re-grow on teeth that are completely clean within 3-4 hours of brushing. You also need to maintain regular dental hygienic cleanings at your dental office – at least every 6 months (or sooner if recommended).

Brushing with toothpaste (also called a "dentifrice") is important for several reasons. First, a toothpaste and a correct brushing action work to remove plaque, a sticky, harmful film of bacteria that grows on your teeth that causes cavities, gum disease, and eventual tooth loss if not controlled. Second, special ingredients in the dentifrice help to clean and polish the teeth and remove stains over time. Third, toothpastes help freshen breath and leave your mouth with a clean feeling.

As long as your toothpaste does not contain fluoride, the brand you buy really does not matter, whether or not it is in paste, gel, or even powder form, or containing a certain flavor. All dentifrices work effectively to fight plaque and cavities and clean and polish tooth enamel. Your dentifrice brand should also bear the American Dental Association (ADA) seal of approval on the container, which means that adequate evidence of safety and efficacy have been demonstrated in controlled clinical trials. If your teeth are hypersensitive to hot or cold, consider trying a dentifrice designed for sensitive teeth. Dentifrices containing baking soda and/or hydrogen peroxide (which are both good cleansing agents) give the teeth and mouth a clean, fresh, pleasant feeling that can offer an incentive to brush more. Some prefer a tartar control toothpaste containing pryo-phosphates to prevent the buildup of soft calculus deposits on their teeth. New pastes offer advanced whitening formulas aimed at safely removing stains to make teeth brighter and shinier, although they can't nearly match the effectiveness of a professional whitening formula administered or prescribed by a dentist.

Contrary to what toothpaste commercials show, the amount of paste or gel needed on your brush for effective cleaning does not have to be a heaping amount. Simply squeeze on a pea-sized dab of paste on the top half of your brush. If you brush correctly holding the toothbrush at a 45-degree angle and brush inside, outside and between your teeth, the paste should foam enough to cover all of your teeth. Children under 6, however, should only be given a very small, baby pea sized dab of dentifrice on their brush.

Yes. Even though teeth are protected by a hard layer of enamel, they can become worn out from improper tooth brushing. Toothbrush abrasion can occur on the crown of the teeth as well as in the softer cementum that covers the tooth roots, which can be exposed by receding gums. These exposed surfaces can become more prone to decay. When you brush, be sure to use gentle, short, tooth-wide strokes.

If you wake up with dull headaches or vise-like pain, you may be one of many people who grind their teeth at night. Many people are unaware they even have the disorder (called bruxism) because it often occurs at night during sleep. Your dentist can usually detect the telltale signs of wear on your teeth. Bruxism is the technical term for grinding and clenching that abrades teeth and may cause facial pain. People who grind and clench, called bruxers, unintentionally bite down too hard at inappropriate times, such as in their sleep. In addition to grinding teeth, bruxers also may bite their fingernails, pencils and chew the inside of their cheek. People usually aren't diagnosed with bruxism until it is too late because so many people don't realize they have the habit. Others mistakenly believe that their teeth must touch at all times. About one in four people suffer from bruxism, which may be able to be treated by our dentists. Click here for detailed information and video.

Bruxism can either directly or indirectly cause many problems. Grinding can cause teeth to become painful or loose. Patients can literally grind away parts of their teeth, leaving them with worn surfaces or fractured enamel. People who have otherwise healthy teeth and gums can clench so often and so hard that over time their teeth become sensitive, and they experience jaw pain and headaches. Forceful biting when not eating may cause the jaw to move out of proper balance. Click here for detailed information and video.

Grinding is a common occurrence among many people at some time or another. If you develop facial pain, fatigue or other problems, treatment may be needed. Talk with your dentist if you suspect that you are grinding your teeth. During regular dental visits, we usually check for physical signs of bruxism. If we notice signs of bruxism, the condition may be observed over several visits to be sure of the problem before recommending and starting therapy. When a person has bruxism, the tips of the teeth look flat. Teeth are worn down so much that the enamel is rubbed off, exposing the inside of the tooth, which is called dentin. When exposed, dentin may become sensitive. Bruxers may experience pain in their temporomandibular joint (TMJ), the jaw that may manifest itself as popping and clicking. Women, who are more susceptible to TMJ, also have a higher prevalence of bruxism possibly because they are more likely to experience tissue alterations in the jaw resulting from clenching and grinding. Tongue indentations are another sign of clenching and grinding. Stress and certain personality types are at the root of bruxism. For as long as humankind has existed, bruxism has affected people with nervous tension. Anger, pain and frustration can trigger bruxing. People who are aggressive, competitive and hurried also may be at greater risk. Click here for detailed information and video.

More research is needed to determine the exact cause of bruxism, but it is thought that both emotional and physical factors are involved. Some of the contributing factors may be stress or sleep disorders, an abnormal bite or crooked or missing teeth. Click here for detailed information and video.

There are a number of ways to treat bruxism. Our cosmetic dentists will determine which single treatment or combination of treatments is right for you. When stress is the major cause of bruxism, people need to find ways to relax. People who have difficulty handling stress may need to seek counseling or our dentist may prescribe muscle relaxants to relax jaw muscles. We may prescribe a night guard, which prevents grinding from occurring during sleep. To help alleviate muscle pain, physical therapy may be needed. The objective of therapy is to get the bruxer to change behavior by learning how to rest the tongue, teeth and lips properly. When some people become aware of their problem, simply advising them to rest their tongue upward with teeth apart and lips shut may be enough to change their behavior and relieve discomfort. However, the dentist can make a plastic mouth appliance, such as a night guard that's worn to absorb the force of biting which causes damage and pain and also helps to change patient behavior. Click here for detailed information and video.

A night guard is a plastic mouth guard worn at night to prevent tooth grinding. A bite plate is a removable plastic device, which prevents teeth from coming together. In some cases, such as with an overbite, it may eventually improve the bite. A method used to treat the damage caused by more serious cases of grinding involves reshaping or reconstruction of the biting surfaces with crowns or inlays or a full mouth restoration. If designed correctly, protective bite appliances help keep teeth from moving, protect ceramic restorations, and protect teeth from wear damage caused by grinding or clenching. Click here for detailed information and video.

Many options can be suggested during a cosmetic consultation, including porcelain veneers, crowns, bonding, orthodontics or simply cosmetic contouring of the teeth.

While the VELscope system can help clinicians discover several types of abnormal tissue in the oral cavity, it is perhaps best known for its ability to assist in the discovery of oral cancer and precancer.

• A deadly disease - One North American dies of oral cancer every hour of every day. The disease claims over twice as many lives as cervical cancer.
  
• A disfiguring disease - Oral cancer is perhaps the most disfiguring type of cancer. It often requires surgery that can grossly distort the patient's physical appearance and chemotherapy and/or radiation that can cause them to lose their sense of taste and experience great difficulty in eating and maintaining their appropriate weight.
• A disease that is not going away - Unlike most types of cancer, the number of new cases of oral cancer has not declined materially in the past three decades. One reason: numerous studies suggest that oropharyngeal cancer—often in the tonsils or the base of the tongue—is associated with the sexually-transmitted human papilloma virus or HPV.
• A disease that can strike almost anyone - In addition to tobacco and alcohol users, any person who is sexually active is at risk of developing the disease. This is why health experts recommend that all adults receive an oral cancer exam on at least an annual basis.
• A disease that can be tamed - Oral cancer's high mortality rate is due to the fact that the disease is usually discovered in late stages, when the 5-year survival rate is only 20%-to-30%. But when discovered in early stages, the survival rate leaps to 80%-to-90%. By supplementing the white light oral cancer exam with the VELscope system, clinicians can see cancerous and precancerous lesions that might not be apparent to the naked eye. In fact, the VELscope system is the first product cleared by the FDA and Health Canada to make that claim.

Click here for detailed information and video.

Click here for detailed information and video.

See Crown

In the old days, cavity detection was routinely conducted with the jabbing, poking and probing that patients don't particularly enjoy. Over the years, cavity detection dyes were developed to help with the diagnostic process. Using a dental explorer is still required to rule out "false positives" that detection dyes are known for generating. Diagnodent, a digital laser device favored by many dental practices, uses modern laser technology to detect and assess caries. The use of a dental explorer is significantly minimized and is minimally invasive. Records of digital assessments of given tooth structures enable a dentist to monitor the changes in decalcification, an indicator of caries development. Click here for detailed information and video.

Chewing gum is not related to the treatment modality and is not in the armamentarium of a dentist. Every reference to chewing gum as a substitute for a thoughtful preventative dental program sells a lot of gum but does little to your oral health if you do not seek regular exams and professional cleaning with your dentist.

Chewing tobacco, sometimes referred to as smokeless tobacco, is not safe, because just like cigarettes, it contains addictive nicotine and dangerous chemicals. In addition, chewing tobacco is processed with nearly as much sugar as there is in candy. Click here for detailed information and video.

See Broken Tooth.

You should have your teeth checked and cleaned at least twice a year, though your dentist or dental hygienist may recommend more frequent visits.

Regular dental exams and cleaning visits are essential in preventing dental problems and maintaining the health of your teeth and gums.  At these visits, your teeth are cleaned and checked for cavities.  Additionally, there are many other things that are checked and monitored to help detect, prevent and maintain your dental health.  These include:

As you can see, a good dental exam and cleaning involves quite a lot more than just checking for cavities and polishing your teeth.  We are committed to providing you with the best possible care, and to do so will require regular check-ups and cleanings.

Click here for detailed information and video on dental exams.

Click here for detailed information and video on dental cleanings.

A licensed dentist in this state is required to complete an oral examination prior to beginning treatment (including teeth cleaning) on a new patient.  The majority of dental offices in this state do require x-rays be taken along with the exam prior to beginning treatment on a new patient.  This type of policy ensures that a thorough diagnosis is obtained.  You have the right, of course, to seek treatment elsewhere if you disagree with office policy regarding x-rays.  However, the dentist has a professional obligation to provide treatment that he/she feels is in the best interests of the patient.  If the patient doesn't cooperate, the dentist is under no obligation to proceed with treatment.  See Nevada Administrative Code (NAC) 631.210.

Nevada State Board of Dental Examiners FAQ

Cold sores, also called fever blisters or oral herpes, are small sores that form most commonly on or near the lips. Cold sores usually follow a predictable pattern of four stages that lasts about 10-14 days. The first symptom is a painful, itchy tingling. A day or so later, small red blisters appear. Then, in a few days, the blisters form into oozing sores with yellowish crusts. Finally, in a week to 10 days, the sores scab over and heal.

Outbreaks can be accompanied by low fever, headaches, body aches and fatigue. Cold sores are painful and annoying, but be patient. They do go away on their own, and you will soon be pain-free again.

Cold sores are caused by the herpes simplex virus. Symptoms appear from 1-3 weeks after initial exposure. Once you are infected with the virus, it lives in your nervous system forever. Certain triggers seem to set off outbreaks. Some of these triggers include exposure to ultraviolet light, physical and emotional stress, fatigue, hormone fluctuations, the menstrual cycle, and illnesses like fever, cold or flu. Click here for detailed information and video.

If you're feeling somewhat self-conscious about your teeth, or just want to improve your smile, cosmetic dental treatments may be the answer to a more beautiful, confident smile.

Cosmetic dentistry has become very popular in the last several years, not only due to the many advances in cosmetic dental procedures and materials available today, but also because patients are becoming more and more focused on improving their overall health.  This includes dental prevention and having a healthier, whiter, more radiant smile.

There are many cosmetic dental procedures available to improve your teeth and enhance your smile.  Depending on your particular needs, cosmetic dental treatments can change your smile dramatically, from restoring a single tooth to having a full mouth make-over.  Ask your dentist how you can improve the health and beauty of your smile with cosmetic dentistry.

Examples of Cosmetic Procedures

Teeth Whitening - Bleaching lightens teeth that have been stained or discolored by age, food, drink and smoking.  Teeth darkened as a result of injury or taking certain medications can also be bleached, but the effectiveness depends on the degree of staining present.

Composite (tooth-colored) Fillings - Also known as "bonding", composite fillings are now widely used instead of amalgam (silver) fillings to repair teeth with cavities, and also to replace old defective fillings.  Tooth-colored fillings are also used to repair chipped, broken or discolored teeth.  This type of filling is also very useful to fill in gaps and to protect sensitive, exposed root surfaces caused by gum recession.

Porcelain Veneers - Veneers are thin custom-made, tooth-colored shells that are bonded onto the fronts of teeth to create a beautiful individual smile.  They can help restore or camouflage damaged, discolored, poorly shaped or misaligned teeth.  Unlike crowns, veneers require minimal tooth structure to be removed from the surface of the tooth.

Porcelain Crowns (Caps) - A crown is a tooth-colored, custom-made covering that encases the entire tooth surface restoring it to its original shape and size.  Crowns protect and strengthen teeth that cannot be restored with fillings or other types of restorations.  They are ideal for teeth that have large, fractured or broken fillings and also for those that are badly decayed.

Dental Implants - Dental implants are artificial roots that are surgically placed into the jaw to replace one or more missing teeth.  Porcelain crowns, bridges and dentures can be made specifically to fit and attach to implants, giving a patient a strong, stable and durable solution to removable dental appliances.

Orthodontics - Less visible and more effective brackets and wires are making straightening teeth with orthodontics much more appealing to adult patients.  Also, in some cases, teeth may be straightened with custom-made, clear, removable aligners that require no braces.

Thanks to the advances in modern dentistry, cosmetic treatments can make a difference in making your smile shine! Click here for detailed information and video.

It has been said, "You never get a second chance to make a first impression." Based on your smile, the world assesses your openness, friendliness, intelligence, personality and even social status! Your smile not only has a dramatic effect on your physical attractiveness, but your self-esteem. Your smile is a key part of your unique look, personality and how the world sees you. Therefore, it is a crucial factor in your image, self-expression and how you interact with others. So just imagine how having an attractive new smile could supercharge your confidence, improve your personal relationships, enhance your ability to communicate, and show others the real you.

Many cosmetic procedures are irreversible, and may require a serious financial commitment, so your choice of a cosmetic dentist is a critical decision that should be made after careful consideration. Therefore, it is critical that cosmetic dentistry be performed with uncompromising attention to detail so that it is done correctly the first time.

Any general dentist who performs a teeth whitening can claim to be a cosmetic dentist. However, if you are looking to get a Hollywood smile, what should you look for? Ultimately, your choice of a cosmetic dentist is a personal decision with which you must be very comfortable. From discussions with our patients, we believe the most important criteria include the following:

• Take Your Time, Do Your Homework - Most cosmetic dental procedures are elective procedures, not emergencies. Time spent learning about the dental procedures, different techniques and materials, and cosmetic dentists you are considering, will pay great dividends in terms of your understanding and emotional comfort later. Ask lots of questions. Ask the cosmetic dentist about his or her training, credentials, experience in performing cosmetic dentistry. Ask to take a tour of the office, including sterilization areas, and ask about technology and materials used in the practice. You are also well advised to review testimonials, ask for references of patients with cases similar to yours, and ask about available warranties and payment plans. You may also want to check with the state licensing board to verify that the dentist does not have a history of complaints or adverse State Dental Board action. In Nevada, you can do this by logging onto the Nevada State Dental Board website: http://www.nvdentalboard.nv.gov/Vertification.htm.
• Post Graduate Cosmetic Dental Training - To perform cosmetic dental procedures at the highest level, an artistic eye, technical skill, and a rigorous program of post-graduate training in cosmetic dentistry is needed. The vast majority of dental schools don't teach any courses in cosmetic dentistry. For the few that do, they are usually limited to only a few introductory courses. Therefore, it is crucial that the cosmetic dentist you select continually complete hands-on courses in cosmetic dentistry. The field changes rapidly; what was state-of-the-art five or ten years ago is not state-of-the-art anymore. The significance lies, not only in developing the dentist's clinical judgment and technical skill, but also in demonstrating his/her commitment to practicing cosmetic dentistry at the highest level of excellence.
• Extensive Smile Design Experience - Before you randomly select a dentist out of the phone book or rely on your long-time family dentist to give you the smile design of your dreams, think again. Great cosmetic dentistry is an art. The fact is, many dentists are generalists who simply have not performed cosmetic smile designs very many times or with a regularity that leads to mastery of this art. So, if you are considering veneers, for example, you should ask how many veneers the cosmetic dentist has placed.
• Portfolio - You'll want to look at before and after photos of cosmetic dentistry that has actually been performed by the dentist that you are considering. Dentists who are dedicated to the art of cosmetic dentistry always take before and after photographs of their cases. You want to confirm that you are seeing actual work of the dentist you are considering, and make sure that the cases are similar to yours.
• Integrity - Find a cosmetic dentist who is honest in his/her assessment of your needs and of their ability to meet your expectations. Be wary of the doctor minimizing your recovery period and telling you just how "easy and simple" everything is going to be.
• A Caring Approach and Great Communication - Find a doctor with a good chair-side manner who conveys to you that he/she cares about you as a person as well as a client. Cosmetic dentistry is a process, not a single operation. Find someone with whom you can talk easily. It's just as important that he/she understands what you desire as that you understand what they are describing. To accomplish these goals, the first thing the cosmetic dentist should do is listen and make sure he or she understands all of your concerns, needs and desires as they relate to your dental health and the look of your smile. Only then should they spend time diagnosing and consulting on the recommended treatment plan, which should be individualized for each person.
• A Sense of Perfectionism - Find a cosmetic dentist who is accurate in his/her evaluation of your needs, precise in the execution of their operative plan, and meticulous in their craftsmanship. Although perfection is in the eye of the beholder, this doctor will do whatever it takes without cutting corners, not only to satisfy you, but also to meet their own personal standards of excellence. Make sure the cosmetic dentist addresses not just the teeth but also gums, lips, facial structure and your specific requests.
• An Artistic Eye - While technical virtuosity is necessary to produce a great clinical result, it is not sufficient. Excellent cosmetic dentistry demands a highly sophisticated artistic sense. In order to achieve an optimal aesthetic result, one must have a clear vision of what is artistically possible and appropriate. In this regard, it helps greatly if the cosmetic dentist works closely with the master ceramist, talking with them about the desired aesthetic results.
• Get A Second Or Third Opinion - If in doubt, see a couple different cosmetic dentists for a consultation. This will clarify in your own mind those personal characteristics that you would like your cosmetic dentist to have. Dr Wright is happy to provide a complimentary opinion and consultation.
• Professional Cosmetic Dentistry Credentials - In dentistry as in medicine, specialties exist that indicate a higher level of education, knowledge and expertise in particular areas of focus. Presently, however, there is not an American Dental Association (ADA) recognized specialty in cosmetic dentistry. In 1984, the American Academy of Cosmetic Dentistry (AACD) was formed and has filled the dire need for credentialing in this area. Presently, with approximately 5,000 members in the U.S. and in 40 countries around the world, the AACD is the largest international dental organization dedicated specifically to the art and science of cosmetic dentistry. The AACD also administers the leading accreditation program for cosmetic dentistry. The accreditation process is a rigorous program, which requires dentists to attend a number of continuing education courses in cosmetic dentistry, be tested, and submit a number of cosmetic cases to be judged by a panel of cosmetic dentistry experts.
• Accreditation in the American Academy of Cosmetic Dentistry (AACD) www.aacd.com/public.html. Following are definitions of AACD membership levels:
  
  
  • An Accredited Fellow - the highest credential earned. In addition to meeting the rigorous requirements of an Accredited member, an Accredited Fellow has successfully completed cosmetic dentistry that meets the Accreditation standard of excellence set forth by the American Board of Cosmetic Dentistry for an additional 45 patients. By successfully completing this process, an Accredited Fellow demonstrates a continued ability and sustained commitment to deliver excellence in cosmetic dentistry.
  • An Accredited Member - successfully completed the comprehensive Accreditation process, which consists of a written examination, delivering and extensively documenting a broad range of cosmetic treatment solutions for five patients and an oral examination administered by the American Board of Cosmetic Dentistry. By successfully completing this process, an Accredited member demonstrates a very high level of clinical skill and ability in cosmetic dentistry.
  • An Accreditation Candidate - a member who has passed the Accreditation Written Examination, as well as delivered and extensively documented one of the five required cosmetic treatment solutions for a patient to the standard of excellence as established by the American Board of Cosmetic Dentistry.
  • A Sustaining Member - attended two of the last four AACD Annual Scientific Sessions, and has passed the Accreditation Written Exam. The Accreditation Written Exam is the first step in the Accreditation process.
  • A Participating Member - a General Member who has attended two of the last four AACD Annual Scientific Sessions.
  • A General Member - a dentist or a technician who is interested in continuing education in cosmetic dentistry. Credentialing is not necessary for general membership.

See Broken Tooth.

Invisalign braces and veneers may be viable options.

See Orthodontics - What is a crossbite?

See Full Mouth Restoration and Orthodontics

A crown is a restoration that covers, or "caps", a tooth to restore its normal shape and size, strengthening and improving the appearance of a tooth. Crowns are necessary when a tooth is generally broken down and fillings won't solve the problem. If a tooth is cracked, a crown holds the tooth together to seal the cracks so the damage doesn't get worse. Crowns are also used to support a large filling when there isn't enough of the tooth remaining, attach a bridge, protect weak teeth from fracturing, restore fractured teeth, or cover badly shaped or discolored teeth. Click here for detailed information and video.

To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of the teeth and gums are made and sent off to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown is made. On the next visit, the cosmetic dentist removes the temporary crown and cements the permanent crown onto the tooth. Click here for detailed information and video.

Some restorations are designed with a metal lining, covered with porcelain (porcelain-fused-to-metal or PFM). At one point in time, most restorations were made this way. When placed, they usually look opaque or "flat" because they do not let light pass through like a natural tooth. There is often a tell-tail dark line next to the gum-line that is undesirable (often the darkness invades the adjacent gum tissue as an adverse reaction). Click here for detailed information and video.

When properly seated, all porcelain crowns are as strong, or stronger, than their metal predecessor. And the appearance can be identical to a natural tooth, allowing light to pass through (referred to as translucency), and much more attractive. Click here for detailed information and video.

As soon as you are seated, we will numb the area to be worked on using a local anesthetic. Depending upon the type of local anesthetic used, you can expect to feel numb for 1-4 hours. If your anesthesia should last longer, do not be concerned. Individuals react differently to anesthesia. While they are numb, please be careful not to bite your lip or tongue. You may want to consider a soft diet or no meal at all until your sensation returns in the affected area.

Once the appropriate area is numb, the dentist will prepare the tooth to maximize the function, retention and aesthetics of your new crown. After the tooth is fully prepared, we proceed to the impression state where we create a model of your prepared tooth for the lab to custom-fabricate your crown. Should you experience any discomfort you can take a mild analgesic (Tylenol, Advil, or aspirin, etc.) as long as there is no medical contraindication based upon your medical history. Typically, you can take anything you would normally take for a headache. If the discomfort persists, please call our office. Click here for detailed information and video.

To prevent damaging or fracturing a new crown, avoid chewing hard foods, ice or other hard objects, just like you should avoid for your natural teeth. You also want to avoid teeth grinding. Besides visiting our office, and brushing twice a day, cleaning between your teeth is vital with crowns. Floss or inter-dental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in the area can cause dental decay and gum disease.

Give our office a call as soon as possible, and we will provide you with specific instructions, and also make arrangements for you to come in and have it re-cemented. In the meantime, we will usually suggest that you simply place the temporary crown right back on your tooth. Doing so will protect the tooth from irritating stimuli such as hot or cold foods and liquids. Wearing the temporary crown will also hold the tooth in place and keep it from shifting position (an important factor in how well or how easily your permanent dental crown can be fitted).

If the bite on your temporary crown seems incorrect when it is placed back on your tooth, it might be advisable to leave the temporary crown off. If your temporary dental crown doesn't seem to stay in place very well, many dentists will suggest that you fill it with toothpaste, Vaseline, or denture adhesive before you place it over your tooth (this technique should only be used for a few days). You will need to be careful with your temporary crown in this state.  So that you don't end up swallowing or biting on it unexpectedly, your temporary crown should be removed when you sleep and eat. Anytime your crown is not in your mouth you should keep it wet. Put it in a glass of water, or seal it inside a baggie containing a moist paper towel.

Crowns require more tooth structure removal; hence, they cover more of the tooth than veneers. Crowns are stationary and are customarily indicated for teeth that have sustained significant loss of structure, or to replace missing teeth. Crowns may be placed on natural teeth or dental implants.

Crown lengthening exposes more of the natural tooth by reshaping or recontouring bone and gum tissue. It is generally performed in order to improve the health of the gum tissue, or to prepare the mouth for restorative or cosmetic procedures. In addition, crown lengthening procedures can also be used to correct a "gummy" smile, where teeth are covered with excess gum tissue. This treatment can be performed on a single tooth, many teeth or the entire gum line, to expose a pleasant, aesthetically pleasing smile. Click here for detailed information and video.

When heavy plaque and tartar deposits have built up on your teeth, we often recommend a procedure called full mouth debridement to remove that buildup. Click here for detailed information and video.

We perform general dental procedures including exams, x-rays, cleanings, restorations, fillings, root canals, etc. The difference is that we practice dentistry with the aesthetics of the final result in mind, so we place a special emphasis on making you look great. Smile Design is our primary focus, which includes Full Mouth Restoration, Invisalign, Snap-On Smiles, Lumineers, porcelain veneers, crowns, bridges and whitening.

Smile Design is a highly technical process requiring great skill and experience to achieve a natural result. It is not taught at all or only touched upon in dental school. Dentists must learn the techniques in post graduate courses and then perfect the art through extensive experience. For this reason, most dentists do not focus on this discipline.

It takes artistic ability and extensive knowledge to perform an impeccable Smile Design. Techniques require precise measurements based upon mouth shape, gum lines, lips and natural shape of the teeth. That's why we devote time to precisely planning a Smile Design before we begin the actual procedure.

During a patient's initial cosmetic consultation, our team can download a digital photograph into an imaging program and show the patient what their new smile can look like. Extensive Smile Design treatments may require as few as two appointments that are typically several hours each depending on the complexity.

There are several ways to progress with an immediate denture. When someone has all their natural teeth extracted for what ever reason and have their first ever upper or lower denture placed, it is known as an "immediate" denture. Immediate dentures are usually more of an investment for the patient due to the fact that more time and effort is going to be needed by the dentist and dental team to adjust and reline this new denture.

After teeth in either jaw are removed, the jawbone will naturally shrink back and resorb a bit, thus making the new "immediate" denture a bit loose and wobbly and less retentive. To help tighten these loose dentures, the dentist, or a lab, can reline and adjust these same dentures. Many patients can get accustomed to these relined dentures and do fine. Also, many new denture wearers elect to have a new set of dentures made once their jawbone has healed and the bone shrinkage has stopped. The original relined immediate dentures can now be kept as a spare set in case they are needed in the future.

A very important concern to think about for the future prevention of continuing jawbone shrinkage and denture retention problems is the use of even a few titanium dental implants. Dental implants are placed in the jawbone, and act like natural tooth roots, to help hold in the denture and to stimulate the bone of the jaw, so it does not resorb away from pressure necrosis. This is especially true for the bottom jaw because unlike the top maxillary jaw and roof of the mouth that can form a tight seal with good suction, a lower denture has to balance on the lower jawbone.

Many denture wearers have most of their problems with their lower dentures due to jawbone shrinkage, and not being able to get the same suction and retention like their upper dentures. The amazing fact is that having as few as 2-4 dental implants in the lower bottom jaw will help prevent future jawbone loss, and keep the lower denture tight and unbelievably retentive and solid.

Many patients start with inexpensive trial dentures to work out all the fine cosmetic and phonetic (speech) details. Once refined, a specialized cosmetic makeover dental laboratory fabricates the final gorgeous cosmetic makeover dentures based on the guidelines obtained from the trial dentures. Once the patient receives their new natural-looking cosmetic smile, the trial dentures are kept as spares.

Cosmetic dentists who have a special talent to produce these drop dead gorgeous makeover dentures are seeing more and more baby boomers and seniors who want to look and feel more youthful with natural looking cosmetic dentures. The unique thing about these advanced dentures is the time and skill-level of the laboratory artists who create them. Special care is taken to make them look like a natural smile and not like a typical picket fence-like dentures. Realistic blood vessels and tooth root formations are added to the surface of the dentures as well as "orange peel" stippling of the outer surface of the dentures to mimic healthy normal looking gum tissue. The teeth in the upper front are vibrant and natural looking porcelain teeth that are custom arranged to fit the gender, and facial size and shape of the specific patient, as these are not off the shelf cookie-cutter dentures.

Click here for detailed information and video.

Click here for detailed information and video.

Yes. Diabetes causes an increase in bone loss and periodontal disease, as well as numerous cavities. You are prone to losing your teeth at a fast rate. Ask the dentist to evaluate for periodontal disease. Click here for detailed information.

See Gap

Eating right needs to be a daily habit, just like brushing and flossing. Eating a balanced diet will help boost your body's immune system, so you will be less vulnerable to oral disease. It will also provide you with the nutrients your body needs to maintain strong teeth and healthy gums. So what is a balanced diet? It includes plenty of fruits and vegetables, moderate portions of protein, complex carbohydrates like whole grains and beans, low-fat dairy products and unsaturated fats. Click here for detailed information and video.

Discoloration occurs in the enamel and can be caused by medication, coffee, tea and cigarettes. Discoloration also can be caused by your genetic make-up or simply getting older.

Tetracycline is an antibiotic used to treat a number of illnesses. One of its major drawbacks is that it causes severe staining in teeth if it is used in growing children ages 3-14. These teeth have a gray, dark brown or sometimes a striped appearance to them. Such discolored teeth may not satisfactorily respond to whitening treatments. The only practical way of eliminating the staining is by covering it up by the placement of porcelain veneers or crowns.

It's like pouring acid in your mouth. Your teeth will melt away slowly. The only things you can do is use Gel-Kam or Perio + Fluoride to slow down the breakdown, but it's kind of like putting water on a chemical fire. You need professional help.

Although some cases of dry mouth are naturally occurring, most cases are caused by one of these factors; prescription medications (usually prescribed for high blood pressure or depression) antihistamines, adult beverages, and mouthwashes with alcohol in them.

When your mouth is dryer, you have less saliva. Saliva naturally contains Oxygen, which keeps your mouth healthy and fresh. These bacteria are anaerobic, which simply means that they will thrive and make more sulfur in the presence of little or no oxygen.

Thus if you have less saliva, you have less oxygen, thereby creating an anaerobic environment, perfect for the bacteria to produce more of these odorous and sour/bitter compounds. For people with Dry Mouth (Xerostomia), products such as Biotene can provide relief.

In summary, many patients have found relief with TheraBreath and Biotene products, check your pharmacy. Stay away from mouthrinses that contain alcohol.

A dry socket is a bone infection after a recent extraction, 3-4 days. It is characterized by extreme pain near the extraction site.

What you seem to be describing appears to be gum recession due to toothpaste abrasion. This is a very common condition and should be checked by the dentist. We usually fill these areas in with tooth colored filling material.

Crest White Strips can cause sensitivity in these areas. If sensitivity occurs, discontinue use and seek advice from the dentist.

Also discontinue use of whitening toothpaste and switch to regular toothpaste. Whitening toothpaste is more abrasive and can accelerate this abrasion.

Once your natural teeth are gone, they're gone forever. That's why we encourage patients to try and save their teeth for a number of reasons.

If a tooth that can be saved is pulled, it will lead to overstressing the other teeth and can result in their loss as well. Tooth loss can cause ineffective chewing, and this can result in the swallowing of large chunks of food.  This is because without teeth you don't chew food efficiently, which overworks the digestive disorders. People who don't have their own teeth have a difficult time consuming a high fiber diet, recommended by the American Cancer Society for the prevention of cancer.

Tooth loss leads to bone loss in jaws. Many young denture patients appear prematurely aged due to the bone loss they experience after having their teeth pulled. With today's great emphasis on having a youthful appearance, regardless of one's age, saving your teeth is indeed a wise investment.

Dentures, bridges and implants are the most common options for replacing missing teeth. Dentures are colorized by mouth bacteria and pick up odors and stains. They must be taken out at night or they can lead to a yeast infection of the gums. Dentures are a good choice for patients who have no hope of saving their teeth. To be able to wear a denture comfortably requires sufficient retention. Bone is invariably lost when teeth are pulled and then continues to reabsorb and shrink back, resulting in poor fitting loose dentures. These consistently require reapplication and never function as effectively as natural teeth. Bridges are preferred by many patients over dentures because they are permanent; they are similar to dentures but are not removed. Today, dental implants used to anchor a tooth restoration add stability and provide a better choice for patients that have missing teeth. Most times, in partnership with our patients, we can establish good functioning, aesthetically pleasing, and long-lasting replacements for natural teeth.

Click here for detailed information and video.

Our fees are comparable to those at premier cosmetic dental boutiques nationally. If you are price shopping for cosmetic dental care, bear in mind that all cosmetic dental offices are not alike. Just like all restaurants, cars or hotel rooms are not the same, and you would never purchase one because it was the cheapest one you could find. With such a high level of artistry, technology, and science needed for optimal results, there are at least two healthcare professionals you should not skimp on: your brain surgeon and your cosmetic dentist. This is not to say that our office is necessarily higher on the specific treatment you may need. In fact, depending on the procedure, our fees may be lower than other cosmetic dental practices. We encourage you to experience what separates us from the other cosmetic dental practices, before making a life-altering decision based on price alone. We are confident you will agree that our services are value priced.

The three most common types of filling materials are amalgam, composite and porcelain.

• Amalgam Mercury Silver Fillings - Amalgam fillings (sometimes called "silver fillings") are a mixture of mercury liquid and small pieces of silver and other metals such as copper, tin and zinc. Because we are a mercury free mercury safe practice, we do not use or recommend these toxic fillings. Click here for detailed information and video.
• Composite Resin Fillings - A composite resin is a tooth-colored plastic mixture filled with glass (silicon dioxide). Introduced in the 1960s, dental composites were confined to the front teeth because they were not strong enough to withstand the pressure and wear generated by the back teeth. Since then, composites have been significantly improved and can be successfully placed in the back teeth as well. Composites are not only used for restoring cavities caused by decay, but are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth. Composite resin dental fillings were created as an alternative to traditional metal dental fillings. Tooth fillings colored to look like a natural tooth are known as composite resin fillings and are made of a plastic dental resin. Composite resin fillings are strong, durable, and make for a very natural looking smile. Many dental insurance plans cover their use. Click here for detailed information and video.
• Porcelain Inlays and Onlays - The real advances have been made in laboratory processed white porcelain fillings called "inlays" and "onlays". They are beautiful, strong, and usually long lasting. The cost is similar to a gold "inlay" or "onlay".

Over the years, there has been concern as to the safety of mercury amalgam fillings. An "amalgam" is a blend of copper, silver, tin and zinc, bound by elemental mercury. Dentists have used this blended metal to fill teeth for more than 100 years. The controversy is due to claims that the exposure to the vapor and minute particles from the mercury can cause a variety of health problems. The position of Four Seasons Dental & Med Spa is that mercury amalgam fillings are not safe. We endorse the position of The International Academy of Oral Medicine and Toxicology (IAOMT), provided here for your convenience.

www.iaomt.com

IAOMT Status Report on Mercury Amalgam - June 20, 1995

The International Academy of Oral Medicine and Toxicology (IAOMT) imperatively petitions the International Governments to cease and/or restrict the use of mercury-containing dental fillings (also commonly referred to as silver amalgam or dental amalgam).

The position of the IAOMT is based primarily upon the increasing concern in the medical community over POTENTIAL health risks that may be associated with patient exposure to mercury vapour from dental amalgam. These concerns are based upon the convincing scientific medical research which has been published in peer-reviewed journals. A review of this subject has recently been published in the FASEB Journal (Mercury Exposure from Silver Tooth Fillings: The Emerging Evidence Questions A Traditional Dental Paradigm, FASEB J., 9:504-508, 1995).

A specific concern is the medical research from three animal experiments and one human source that have confirmed the transfer of mercury from the fillings of pregnant females into the tissues of fetuses.

The governments of Austria, Finland, Germany and Sweden have already announced plans to stop or limit the use of dental mercury amalgams. Furthermore, after sustaining unrelenting pressure from concerned citizens groups, the Government of Canada has assented to place the mercury amalgam issue under review by regulatory authorities. These above positions, along with those of the medical research scientists, are in direct contradiction to the contentions of the dental profession at large, which adamantly professes that mercury exposure from dental amalgam is harmless, except in rare individuals who are sensitive to mercury.

Advocation of cessation of the use of mercury dental fillings must also be accompanied by addressing a concern for the appropriate removal of the fillings. It is sufficiently documented that the removal of dental mercury amalgam, for any reason, can generate high amounts of mercury vapour. Because of the stringent requirements for the proper removal of dental mercury, the IAOMT has developed a Standard of Care program. This program has been established primarily for the protection of the dental patients and secondarily for dental healthcare personnel.

It should be further noted that lately, increasing attention is being directed, by clinical dental practitioners, towards DETOXIFICATION from mercury exposure. Some of the procedures which are being advocated by these practitioners do not have a valid scientific foundation. The IAOMT urges health care practitioners to approach the issue of detoxification with care and caution.

Because of the nature of academic clinical training, the dental profession at large is very inadequately prepared to address concerns about dental mercury amalgam. Therefore, the IAOMT is in the process of developing a Clinical Certification Program to redress this subject matter. This program, directed by qualified IAOMT members, will promote instruction and certification of clinical practitioners in the IAOMT Standards of Care for mercury amalgam removal. Although individual practitioners may utilize various protocols in their clinical practices, the IAOMT recognizes and supports only those therapies that have a valid SCIENTIFIC orientation.

The International Academy of Oral Medicine and Toxicology is exceptionally gratified to have been instrumental in supporting scientific medical research aimed at clarifying this long-standing issue of dental mercury toxicity. Our primary goal has been directed at providing a SCIENTIFIC RESPONSE to the continuing controversy. In doing so, we have achieved worldwide credibility for our efforts.

Click here for detailed information and video.

Amalgam fillings, bonding and composite resin fillings do not bleach. If you are unhappy with the look, it is time to replace those. There are now many ways to restore teeth with materials that virtually disappear and blend with the natural color of your teeth. Remember, only replace these fillings and bonding after whitening in order to match the new improved color of your own natural teeth.

Most of us have fillings in our mouths that date back many years and some may have even been placed during our childhood. These fillings may now be dark and unattractive, making us feel self-conscious when we smile, laugh and talk. Old fillings are not only unattractive, they may also be defective. When a filling is old, the margins (space between the tooth and filling) may eventually open and allow bacteria and food debris to enter, potentially causing dental decay.

Your dentist can check your fillings and evaluate if they are defective and need replacement. Also, if you simply want to replace fillings that are unattractive, you and your dentist can decide which ones should be replaced first and what replacement options would best suit you. There are many state-of-the-art dental filling materials and procedures available today that are quick, painless and cost effective for replacing old, unattractive or defective fillings.

Options for replacing old, unattractive, or discolored fillings

Composite Fillings (Bonding) - These are tooth-colored fillings that can be closely matched to the color of your existing teeth. They are particularly well suited for use in front teeth or visible parts of teeth and are one of the best ways to improve the health and beauty of your smile.

Crowns (Caps) - These types of restoration are used when a tooth is too damaged and cannot be repaired with a filling or other type of restoration. A crown is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens the remaining tooth structure and can be made of gold, porcelain, and other tooth-colored materials.

Inlays/Onlays - These restorations are custom made fillings. They can be made of composite resin, porcelain or gold and are made by a dental laboratory and placed by a dentist. Inlays/onlays are usually best for the posterior chewing surfaces of teeth and are utilized to conservatively repair teeth that have large defective/unattractive fillings or have been damaged by decay or trauma.

Porcelain Veneers - Used primarily in the front teeth, veneers are very thin shells of tooth-shaped porcelain that are individually crafted and permanently cemented to the front surface of teeth. They are a great solution for fixing discolored, pitted, shipped, malformed, or slightly crooked teeth. Veneers are also used if you have unwanted spaces. Veneers are very durable, natural looking, and do not stain. This makes veneers a very popular solution for restoring a smile impaired by old, unattractive fillings.

As you can see, there are various options for replacing old, unattractive fillings. These treatments will provide strong, natural, and long-lasting replacement solutions to enhance the health and beauty of your smile.

Following preparation, we place the composite in layers using a light specialized to harden each layer. When the process is finished, we will shape the composite to fit the tooth. We then polish the composite to prevent staining and early wear. Click here for detailed information and video.

Brushing our teeth removes food particles, plaque, and bacteria from all tooth surfaces, except in between the teeth.  Unfortunately, our toothbrush can't reach these areas that are highly susceptible to decay and periodontal (gum) disease.

Daily flossing is the best way to clean between the teeth and under the gumline.  Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, and saliva.  The bacteria produce toxins (acids) that cause cavities and irritate and inflame the gums.  Also, when plaque is not removed above and below the gumline, it hardens and turns into calculus (tartar).  This will further irritate and inflame the gums and also slowly destroy the bone.  This is the beginning of periodontal disease.

How to floss properly

• Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
• Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
• Curve the floss into a "C" shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss. Daily flossing will help you keep a healthy, beautiful smile for life! Click here for detailed information and video.

A full-mouth restoration (FMR), sometimes called reconstruction or rehabilitation, is the individual restructuring of each and every tooth in a mouth. FMR is called for where the teeth are worn down, broken down or missing, causing problems in both the bite and appearance of the mouth. The most common solutions to these problems are crown, veneers, on-lays and bridge work. FMR in the hands of a highly skilled dentist is usually so successful that others cannot discern the real natural teeth from restoration teeth. This technique involves some easy preliminary information gathering. FMR is completed in just two appointments: (1) preparation and (2) seating. During the preparation appointment, all old restorations and any decay are removed, impressions are made of the underlying healthy tooth structure, and beautiful temporary teeth are made. These temporaries are worn until the seating appointment, about three weeks later. This appointment involves removing the temporaries and bonding on the final restorations.

You may be a candidate for full-mouth restoration if you have several teeth that are in very poor health, or that are excessively worn causing lost vertical dimension. If you have lost vertical dimension, your teeth appear short, show signs of wear, or if your top teeth nearly or completely overlap your lower teeth. This "vertical dimension" is typically lost from decay, or from teeth "grinding" from stress and/or misalignment of teeth. Other signs of lost vertical dimension are pains in the joints located near your ears, headaches, back pain, muscle pain, clicking and or popping of the jaw joints. Vertical dimension is restored by physically adding to the biting surfaces of all teeth. A material similar to porcelain is used to enhance the height of teeth in the form of a typical crown. It has been estimated that approximately 80% of the general population have lost some vertical dimension.

The first thing that needs to be done is to diagnosis why the space is there. The space can be caused by Para functional habits (such as tongue thrusting, nail biting, thumb sucking, etc); pathology (cysts growing, extra teeth in the gums, periodontal or gum disease, tumors); or developmental and genetic conditions. Ruling out any harmful pathology and correcting any habits, we can now talk about options to minimize the space.

The options vary from braces to full cover crowns (caps on the teeth), with the most common being Porcelain veneers (a thin piece of porcelain place on the front and sometimes side and biting surface of the teeth). Veneers and/or crowns will get the results fast.

There are some rules that must be followed for the result to be pleasing to the eye. Most teeth that we consider beautiful have a few things in common. The top central (middle) teeth are often between 10 and 11.5 millimeters long and 77.5% of the corresponding length wide. 80% of the length width is often acceptable.

In the smile, when seen from straight on we must also follow fixed proportion to have an even and balanced look. This is often referred to as the Golden Proportion and is stated as if the width of the lateral teeth (the teeth on the side of the front teeth) is assumed to be of a value of 1 then the front teeth would be of a proportion of 1.62% in width and the canines (the eye tooth or the next tooth back from the laterals) would be of a proportion of 0.62% of the lateral when seen straight on.

Remember that we are viewing from the very center face on when seen in a photograph. This tooth (the canine ) may be wider if viewed from the side. The teeth (bicuspids) then follow a decreasing proportion as the smile retreats to the back of the mouth.

So when considering closing the space in the front you may need to consider more then just the front two teeth and include the front ten to get the desired effect.

Gingivitis is the mildest and most common form of periodontal disease. It is caused by the toxins in plaque and leads to periodontal disease. People at increased risk of developing gingivitis include pregnant women, women taking birth control pills, people with uncontrolled diabetes, steroid users and people who control seizures and blood pressure using medication.

Gingivitis is easily reversible using a solid combination of home care and professional cleaning. The dentist may perform scaling and root planing procedures to cleanse the pockets of debris. A combination of antibiotics and medicated mouthwashes may be used to kill any remaining bacteria and promote the good healing of the pockets. You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings. Click here for detailed information.

Gum disease, also known as periodontal disease, is the leading cause of tooth loss in adults. Why? Because it occurs at an age when cavities are usually a thing of the past, and the initial symptoms often go unnoticed. Click here for more detailed information and videos.

Gum disease is bacterial infection that attacks the gums and bone supporting the teeth. In its early stages, gum disease is not apparent to the patient. Just as high blood pressure is called the silent killer, so is gum disease the silent killer of teeth. We've learned a great deal about gum disease in recent years. We are now able to diagnose it earlier and help patients get it under control much better than in the past. The earlier we detect it the sooner we can get it under control. If your gums are bleeding, even slightly, it is a sign of gum disease. When patients wait until teeth are loose and painful and their gums are oozing it is much more difficult and costly, if at all possible, to get the disease under control. Click here for more detailed information and videos.

You should watch for gums that bleed when brushing; red, swollen or tender gums; and/or persistent bad breath. Click here for detailed information and videos.

Gum disease can be prevented by brushing at least twice a day, flossing daily, eating a balanced diet, and visiting your dentist regularly, at least every six months (or more if recommended) for a preventive checkup and professional cleaning. Click here for more detailed information and videos.

A gum graft (also known as a gingival graft or periodontal plastic surgery) is a collective name for surgical periodontal procedures that aim to cover an exposed tooth root surface with grafted oral tissue. Exposed tooth roots are usually the result of gingival recession due to periodontal disease. There are other common causes, including overly aggressive brushing and trauma. Click here for detailed information and video.

A gummy smile is a condition where teeth are covered with excess gum tissue, corrected by a procedure called crown lengthening. Crown lengthening exposes more of the natural tooth by reshaping or recontouring bone and gum tissue. This treatment can be performed on a single tooth, many teeth or the entire gum line, to expose a pleasant, aesthetically pleasing smile. Click here for detailed information and video.

For most people the answer is, "absolutely!" A symmetrical and even gum line is one of the most important aspects of getting a beautiful smile. A beautiful smile is like a work of art – the smile is the frame, the gums are the matting, and the teeth are the featured subject. Much like the cuticles on your fingernail, the gums can cover your tooth structure, making your teeth appear short and fat instead of the shape that "Mother Nature" intended. We routinely correct this in most of our smile designs. Gum contouring can be done to reduce the excess gum. The removal of this excess tissue allows for normal sized teeth and for a normal gum line appearance by using an electro-surge or laser to remove the undesirable tissue. Click here for detailed information and video.

Gum tissue protects the tooth root. When the gumline moves away from the visible part of the tooth, exposing the tooth root, we call this gum (gingival) recession. Without gum tissue to protect them, tooth roots become more susceptible to decay and painful sensitivity.

Every case of gum recession is slightly different, and therefore many treatments are available. The nature of the problem which caused the recession to begin with needs to be addressed first.

If overly aggressive brushing techniques are eroding the gums, a softer toothbrush and a gentler brushing technique should be used. If poor oral hygiene is a problem, prophylaxis (professional dental cleaning) may be recommended to rid the gum pockets of debris and bacteria. In the case of a severe calculus (tartar) build up, scaling and root planing will be performed to heal the gingival inflammation and clean the teeth.

Once the cause of the gingival recession has been addressed, surgery of a more cosmetic or restorative nature may be recommended. Gum tissue regeneration and gum grafting are two excellent ways to restore natural symmetry to the gums and make the smile look more aesthetically pleasing. Click here for detailed information and video.

Bleeding gums are almost always a sign of infection. Healthy gums don't bleed. You might want to make an appointment for a checkup and cleaning to include a reading of "pockets", which is the space between where your gums look like they attach to the teeth and where they actually attach. This is like a little turtleneck collar between the gum and the tooth. If the tissue is inflamed, a cleaning or deep cleaning will usually begin to heal the infection. Good home care to include brushing and flossing will also help. See Periodontal Disease

See Bad Breath

Many people are unaware that having periodontal disease (the destruction of gum tissue and bone that hold our teeth in place) can affect your overall health.  Periodontal disease is one of the most common infections; often more prevalent than the common cold!  Periodontal disease is not only the number one reason people lose teeth; it can also affect the health of your body!

Periodontal disease is a bacterial infection, and in its earliest stages, it's called gingivitis.  It starts when an accumulation of plaque (a colony of bacteria, food debris, and saliva) is NOT regularly removed from the gums and teeth.  The bacteria in plaque produce toxins/acids that irritate and infect the gums and eventually destroy the jaw bone that supports the teeth.  When periodontal disease is not treated it can eventually lead to tooth loss!

There are numerous studies that have looked into the correlation between gum disease and major medical conditions.  These studies suggest people with periodontal disease are at a greater risk of systemic disease and indicate that periodontal disease may cause oral bacteria to enter the bloodstream and travel to major organs and begin new infections.  Research suggests that periodontal bacteria in the blood stream may:

Researchers conclude there is still much research to be done to understand the link between periodontal disease and systemic diseases, but enough research has been done to support that infections in the mouth can play havoc elsewhere in the body.

To ensure a healthy, disease-free mouth, we recommend the importance of regular dental check-ups and cleanings, which include a periodontal evaluation.  Also, diligent home care and a proper diet can help reduce the plaque and bacteria in the mouth.

Remember….the mouth body connection!  Taking care of your oral health may contribute to your overall medical health! Click here for detailed information.

Holistic Dentistry refers to the Mouth-Body Connection. Research studies have shown that there is a strong association between periodontal disease and other chronic conditions such as diabetes, heart disease, pregnancy complications and respiratory disease. As a holistic (biological) dentist, Dr. Wright takes into consideration the cause-and-effect relationship between a patient's oral health and the health of the rest of their body. In contrast, a traditional dentist tends to focus on the more mechanically oriented tasks of treating symptoms and repairing structures as problems arise, without looking for root causes. Click here for detailed information and video.

Periodontal disease is a progressive condition which leads to gum inflammation, the recession of bone and gum tissue, and tooth loss if left untreated. There are a variety of effective treatments and procedures available, including pocket irrigation, which can assist in treating the progression of the disease.

Pocket irrigation by means of Hydroflossing aims to cleanse plaque from the interdental (between teeth) and subgingival (under the gumline) regions of the mouth in order to prevent the colonization of harmful oral bacteria. This procedure is also used to deliver antibacterials to the subgingival areas. Click here for detailed information and video.

A natural tooth has a crown - the part which shows above the gumline, and a root - the anchor hidden below the gumline. When a tooth is missing, a dental implant takes the place of the missing root and a prosthetic crown replaces the natural crown. Click here for detailed information and video.

The Implant Procedure - The implant procedure is the same whether one or all teeth are missing. In this example, there is only one missing lower tooth. For the purpose of demonstation we will assume the patient is healthy and is a candidate for this procedure.

Implant Site Preparation - The gum tissue is opened to expose the bone area where the implant will be placed. In situations where there is insufficient bone structure, bone grafting may be a recommended procedure. Once healthy bone material has been established, a special drill is used to prepare the bone to receive the implant.

Placing the Implant - After the bone has been prepared, the implant is placed and the tissue is sutured.

The Healing Process (Osseointegration) - The healing process takes three to six months. This is the amount of time it usually takes the implant to become part of the lower jaw, commonly refered to as osseointegration. The sutures are typically removed however, seven to fourteen days after surgery.

Attaching the Post - When the gum tissue is ready, a special post is attached to the implant. It is the support for the new porcelain crown. Today's technologies often include zirconium abutments attached to the implant post, to assure that the new porcelain tooth possesses translucency properties similar to a natural tooth.

Placing the Crown - After impressions are taken a crown is made and shaded to match your existing teeth. The crown is then slipped over the post and cemented.

The Completed Implant - The final prosthetic crown appears as a natural tooth.

Applications of Implant Dentistry - In many cases, dental implants are incorporated into an overall treatment plan that might focus on the replacement of several teeth. Some patients have the option of replacing each affected tooth with a new implant, depending upon the condition of bone material. Other treatment plans may recommend implants for anchoring bridges and dentures.

Click here for detailed information and video.

Current dental implant technologies and materials continue to develop at a strong pace. The procedure has become established as the procedure of choice when patients are faced with the decision to replace single or multiple teeth. Most restorative and reconstructive dentists can suggest a variety of treatment plans and technologies for replacing any number of teeth. In terms of obtaining optimal restoration of aesthetic appearances and dental function (bite, occlusion, eating, speaking, etc), implants tend to be unsurpassed. The success rate of implants is in the high ninety percent range. However, occasionally they do fail. There are two types of implant failures: Early and Late:

Early Failures - This type of failure occurs shortly after the implants are placed. They can be caused by: overheating the bone, too much force when they are placed, not enough force when they are placed, contaminated implant, contaminated osteotomy, epithilial cells in osteotomy site, poor quality of bone, excessive forces during osseointegration, a myriad of other reasons.

Late Failures - Generally caused by excessive forces and lateral loading.

Treatment success with the "right" implant dentist. Find an implant dentist who has had great success. Oral Surgeons, Periodontists and General Dentists with advanced Post Graduate training comprise this specialty area. Ask lots of questions. Ask to see photographs of before and after photos.

Implantology (placement of implants) is a very technically sensitive procedure. The training, skill and experience are key factors in the success of the procedure. While training is indeed important, evidence of substantial experience (with photography), especially within your interest area, can be even more important.

Prior to having the implant placed, the surgeon should explain everything to you. If you feel that you did not receive adequate information, then wait until you are ready and informed.

Yes, they can be removed but if not replaced, a variety of bone resorption issues may result. Without tooth roots or implant devices, jawbone typically resorbs (disappears) away. In addition, you may need a socket graft for each implant site, especially if there are adjacent teeth since there may be some risk of compromising the stability of those adjacent teeth.

Maybe both, maybe neither... Implant dentistry is a restorative discipline with a surgical component. People do not want dental implants. They want teeth and the sole purpose of the implant is to act as an artificial root.

Oral surgeons are highly trained dentists who have an incredible knowledge of the maxillofacial region of the body. Most have hospital privileges. Patients who have severe medical problems, require complex bone grafting procedures are best served by a team including an oral surgeon. Most of the new oral surgery graduates have training in the surgical placement of implants with limited practical experience. Many experienced oral surgeons have taken the time to become educated in the field as well.

Periodontist practices deal primarily with the treatment of diseases of the gums and bone which support the teeth. They are the plastic surgeons of the mouth. Once again their formal training has implant training and limited practical experience. Many periodiontists have taken the training necessary to place implants. Patients who require periodontal treatment, moderate bone grafting and very precise soft tissue manipulation should consider having a periodontist on the team.

In both of the above cases the team leader must be the restorative dentist. If the implant is placed in a location where in can not be restored properly the long term prognosis may be compromised. To avoid the miscommunication that may happen when multiple doctors are involved consider selecting a doctor who will take responsibility for the entire process.

There is no specialty for implantology. However, there are dentists who have training in the surgical, restorative and esthetic components of implantology. Ask your dentist how many cases that they have completed together. How do they communicate the exact location of the placement of the implant. Will the restorative dentist be present during the surgical procedure if the planned site needs to be altered due to the quantity/quality of bone, or if a different type of implant may be indicated?

When dental implants were first developed back in the 1970s, they weren't very long-lasting. It took a lot of research and development to improve the success rate. Now, after more than three decades of clinical experience with over a million patients treated, statistics show that about 95 percent of individual implants are successful. The rate is even higher for bridges supported by implants. Success is defined as remaining and in function over a five-year period.

How long do dental implants last today? That depends on a couple of factors. One, of course, is how well you take care of them. You need to brush and floss, keeping them clean, to prevent inflammation around the implants.

Second, a lot depends on how well they were put in. Because dental implantology is such a new field and isn't yet a part of the standard dental school curriculum in all dental schools, many dentists are trying to place them when they haven't had the full education required to do them well. Also, many dentists are trying to cut their costs. For example, there are 200 companies making dental implant fixtures. Only six of these, however, produce fixtures certified by the American Dental Association. To be certified, they have to supply research demonstrating that the fixtures are safe and effective. If you have non-certified fixtures placed, your treatment will likely not last as long, because the chances of developing a loose implant, or infection, or other problem will be greater. Certified fixtures are made to very exacting tolerances, and these standards aren't followed for the "generic" fixtures.

But the temptation is high for dentists to use non-certified fixtures, because the high-quality certified ones cost about one hundred times as much. One part of the implant, for example, will cost $300-500 if it is a high-quality, carefully sterilized, exacting tolerance, name brand fixture. The same part will cost $3-5 if it is a non-name brand fixture, made in the Philippines. And the patient won't know the difference until possibly years later.

So how long do the implants last? It depends on you, and on the care and expertise of your dentist. Poor quality treatment can lead to implant failure.

In most cases, placing single or multiple implants doesn't require being put to sleep. However, if you want to be relaxed, we can prescribe some oral sedatives that relax you if you are apprehensive or nervous. Patients who have undergone treatment with mild sedation have really been pleased because they are not totally out, and the recovery is just a fraction of the usual time.

In the mid to late 1990s, the dental implant procedure, All-on-4, was developed as a way to more efficiently use implants in both jaws. It is especially effective treatment for upper arch restoration because longer, stronger implants can be used in the back part of the jaw.

In the early 2000s, implant manufacturer Nobel Biocare collaborated with noted European implant dentist Paulo Malo and began to use computer simulation, bio-mechanics, and clinical research to determine the optimal use of implants for restoring a full upper or lower arch of teeth. The result was a procedure that uses the fewest implants possible, avoids bone graft surgery, and provides high-quality restorative results in the shortest time possible.

The All-on-4 Dental Implant Procedure uses four implants, with the back implants angulated to take maximum advantage of existing bone. Special implants also were developed that could support the immediate fitting of replacement teeth. This treatment is attractive to those with dentures or in need of full upper and/or lower restorations. With the All-on-4 Procedure, qualified patients receive just four implants and a full set of new replacement teeth in just one appointment without bone grafts! The real appeal is how quickly permanent implants can be placed so that patients can leave the same day with fixed, non-removable replacement teeth. Traditional approaches to restoring a full arch of teeth usually involved bone grafts, six or more implants, and as many as 18 months of treatment. That meant that a patient often would be without any teeth, or with ill-fitting temporary dentures for more than a year. All-on-4 patients always leave with teeth!

With the All-on-4 Dental Implant Procedure, the patient has one or two visits to the office to allow the Oral Surgeon, Prosthodontist, and Restorative Dentists to gather information for a treatment plan (e.g., CAT Scan, X-rays, impressions, photos). Following this consultation, the patient is scheduled for surgery implantation and the new teeth are fitted and adjusted, all in one appointment (even when extractions are necessary). The patient comes to the office in the morning with unhealthy (or no) teeth, and leaves in the afternoon with a beautiful set of fixed, functional teeth.

The patient will return for occasional check-ups over the next several weeks and months. After almost six months, when the gums have fully healed and the implants are fused to the natural bone, we will take new impressions of the patient's mouth and prepare a final, stronger, permanent set of teeth adjusted to a perfect fit--at no additional cost. This helps ensure that the teeth will last for decades, and provide maximum support, beauty, and function to the patient.

The concept began in the middle to late 1990's as a way to more efficiently use implants in both jaws. It is an especially effective treatment in the upper jaw since a longer, stronger implant can be used in the back part of the jaw.

In the early 2000's, implant manufacturer Nobel Biocare teamed up with noted European implant dentist Paulo Malo to use computer simulation, bio-mechanics, and clinical research in determining the optimal use of implants for restoring a full upper or lower arch of teeth. The objective was to use the fewest implants possible, avoid bone grafting surgery, and provide high quality restorative results in the shortest time possible.

The study resulted in the introduction of the All-on-4 technique using four implants, with the posterior implants angulated to take maximum advantage of existing bone. Special implants were also developed that could support the immediate placement of the prosthesis (teeth) on the four implants with a success rate equal to or better than the traditional multi-stage treatment approach. The All-on-4 Procedure has now been proven to be reliably successful in restoring a full arch of teeth using just four specially placed implants, all in one day.

The All-on-4 Procedure provides patients with new teeth that are firmly fixed in place, and look and function as close to natural teeth as possible.

A denture or partial denture is a removable appliance, and should be taken out every night for cleaning. Additionally, since a denture is not fixed in place, it will often slip or sometimes fall out, under even normal use. For this reason, a multi-billion dollar market for denture adhesives has developed, to try to hold dentures in place. Even with adhesives, many people find that eating, laughing, being active, and sometimes just talking can be a challenge with dentures.

All-on-4 provides the patient with a set of teeth that are connected to the implants, and are solidly fixed in place (what we call an implant-supported fixed bridge). They may only be removed by the dentist, are brushed and cleaned like normal teeth (though flossing is different), and are the closest thing possible to natural teeth in terms of look, feel and function.

The All-on-4 bridge also allows the patient to bite with much more force than dentures, since the stresses are transferred directly to the bone rather than to gum tissue as with dentures. This means that patients can eat almost any of their favorite foods without worrying about their teeth.

Absolutely not! And this is the beauty of dental implant treatment vs. dentures. Not only will your implant supported teeth be fixed in place, without slipping or needing to be removed for cleaning, but since your teeth are supported by the implants, they do not press on the gum tissue and therefore do not create any of the discomfort common with dentures.

This line will be hidden behind your lips so that when you smile it is not visible. During your initial examination we evaluate your smile to determine where the junction of the fixed bridge and the jaw bone will be. During the procedure, we adjust your "smile line" to ensure that your new smile is not too "gummy" and that the top (or bottom) of your prosthesis is completely hidden.

Research done by Nobel Biocare, and clinical experience at ClearChoice show that in most cases, 4 implants, specially placed with some angulated, are just as effective in supporting a full arch fixed bridge in either jaw as 5,6, or 8 implant restorations. On rare occasions where bone is soft or worn down, additional implants may be needed, but these situations are the exception and usually only in the upper jaw.

In most cases, even the most difficult ones, our doctors are able to place 4 implants and restore a full arch of teeth without bone grafting. This is accomplished by the special placement and angulation of the implants, taking maximum advantage of the available bone, without grafting. Dr. Ole Jensen, author of the textbook THE SINUS BONE GRAFT used in dental schools and by dentists around the world, has discovered that use of the All-on-4 technique can eliminate the need for bone grafting in more than 95% of the full arch cases he treats.

The past approach to restoring a full arch of teeth usually involved 6 or more implants, bone grafting, and as many as 18 months of treatment. That meant that a patient would often be without any teeth, or with a temporary denture for more than a year.

With the All-on-4 Procedure, the patient has one or two visits to the office to allow the dentist to prepare the case (CAT Scan, X-rays, impressions, photos, etc.). Following this initial work-up, the patient is scheduled to have the implants and the new teeth placed, all in one appointment (even when extractions are necessary). The patient comes to the office in the morning with bad (or no) teeth, and leaves in the afternoon with a beautiful set of fixed, functional teeth.

The patient will return for occasional check-ups over the next several weeks and months. After six months, with the gums now fully healed and the implants now fully fused to the natural bone, we will take new impressions of the patient's mouth and prepare a final, permanent set of teeth with additional titanium support in the bridge. This helps ensure that the teeth will last for decades, and provide maximum support, beauty, and function to the patient.

Most dental implant practitioners still use older approaches that require more implants and longer treatment times because they do not have expertise and experience with the All-on-4 Procedure, and they are not set up with the proper facility, imaging equipment, on-site lab, and experienced team necessary to do a one-day All-on-4 Procedure.

Published studies indicate a 98.2% implant success rate when using the All-on-4 technique in the lower jaw. Similar studies show a 97 to 98% success in the upper jaw for the same procedure. Occasionally, an implant will fail. If this happens, we simply place a new implant in a slightly different position to take advantage of existing bone, and our lab refits the fixed bridge to align with the new implant.

For the all-on-four procedure, the implants are placed the day of surgery and follow-up checks are done at one week, two weeks, two months and four months. At the end of the four month period, fabrication of the permanent teeth begins, and requires one or two additional visits over the next few months until the final teeth are delivered.

Solid foods can be eaten by a patient that has undergone the All-on-4 Procedure that same day. However we must define what we mean by solid foods. We are talking about a modified food diet, defined as foods that are soft enough to be cut with a fork. Examples of the modified food diet are scrambled eggs, meatloaf, mash potatoes, hamburger, fish & pasta. Please do not eat foods that require any tearing or biting with your front teeth, i.e., Pizza, sandwiches, and bagels. Also, avoid hard foods such as carrots, chips, apples, nuts and absolutely no gum chewing! This modified diet is to be maintained until you receive your permanent prosthesis, usually about six months. Once your final bridges are made with the titanium frame as reinforcement you can resume a normal diet.

On the day of your procedure we place the implants and a new set of teeth called a "long-term provisional" prosthesis. This provisional set of teeth is fixed in place, is fully functional, and provides you with a beautiful smile. You will laugh, talk, play sports, and be normally active, without having to worry about your teeth.

This provisional set of teeth is made entirely of acrylic resin, which places less stress on your new implants during their first few months of use. We will ask you to be selective in the foods you eat the first few weeks following your procedure, but you will soon be back to a normal diet (without hard, tough, or brittle foods for a while longer).

Once your gum tissues have healed and the implants have become completely stable (usually about six months) we fabricate a permanent bridge with acrylic or porcelain teeth, but this time with a titanium framework inside for strength. Think of the titanium as a reinforcement bar to give your teeth extra support and long-term strength. This permanent set of teeth is carefully adapted to your healed gum tissues and is adjusted to be sure we achieve an ideal fit in your mouth, and that your bite and smile are perfect.

In many cases, where the patient has several broken or missing teeth or has an uneven bite, it is best to do both arches at the same time to avoid compromising the final result. This allows us to control the patient's biting plane and bite. Doing both arches at the same time is a complex procedure, and is beyond the skill level of most dentists. However, we have the specialists, experience and protocols that give us the capability of handling two-jaw cases in one day. In other instances, treatment can be sequenced to meet the financial, health, or other individual needs of the patient.

Very few people who need a full arch of replacement teeth are not candidates for the All-on-4 Procedure. However, each candidate is fully evaluated to determine the most appropriate plan of treatment to address their individual dental needs.

Importantly, all candidates must be stable medically before entering treatment. That may entail contacting your physician about any existing medical conditions, and getting your doctor to provide medical clearance.

In some cases, the All-on-4 Procedure is not the indicated treatment approach. Based upon dental condition, some people are better off being treated with conventional dental procedures done. We initially determine the appropriate treatment approach at the consultation appointment, and confirm that treatment plan at the Prosthetic evaluation. We have on staff a Periodontist, General Dentist, Cosmetic Dentist and Dental Anesthesiologist to make sure anyone receives the most appropriate and the best care possible.

The All-On-Four Procedure may be challenging or difficult to perform on people who have suffered extreme bone loss. Our panel of specialists can consult about your specific situation and find the best course of treatment for you.

Like plastic surgery, insurance does not usually cover treatment done for purely cosmetic reasons. However, treatment that is needed to repair broken or decayed teeth or to replace existing restorations that are defective may qualify for some insurance reimbursement. Click here for detailed information and video.

See Orthodontics Invisalign - What is Invisalign?

We are always on the look out for qualified people to join us. We are committed to provide our patients with the highest possible quality of service and materials. Consequently, we are always on the look out for individuals who possess the following qualifications to join our Four Seasons Dental & Med Spa family: optimistic and enthusiastic attitude, your cup is always half full, sunny disposition, patience, kindness, compassion, consideration and respect for others, easy smile, sense of humor, focused and always on task, emotional and intellectual intelligence, detail oriented, harder on yourself than others, always looking for the best in others, consider the job done when it is complete and not when the clock strikes 5, flexible, willingness to learn, strong work and business ethic, giver and not a taker. Click here for detailed information.

KONG Dental Toys makes a toy product for dogs called the Dental Kong. Providing proper dental care is one of the most important aspects of pet ownership. In fact, dental and gum disease is the number 1 health problem diagnosed by veterinarians. Over 80% of all dogs over the age of 2 have some form of periodontal disease. Left untreated periodontal disease can cause pain, bad breath, tooth loss, and infections that can lead to serious heart and kidney disease. By practicing routine dental care most dental problems can be prevented. Click here for detailed information and video.

As part of our therapy for periodontal disease, we have an effective treatment called Laser Bacterial Reduction that helps us control the infection in your mouth. Laser is used together with scaling and root planing to significantly reduce the depth of the infected pockets and prevent the progression of the disease. The Laser decontamination process is painless and normally takes 5-10 minutes. We recommend that all of our patients have their teeth and surrounding tissues decontaminated during their periodontal maintenance appointments. Click here for detailed information and video.

A sign of rapidly progressing periodontal disease is the loosening or shifting of the teeth in the affected area. As the bone tissue gets destroyed, or periodontal fibers weakened (fibers that support the tooth to the bone), teeth that were once firmly attached to the jawbone become loose or may shift in position. Click here for detailed information and video.

See Sapphire Teeth Whitening

Lumineers is unique in that it is contact-lens-thin (approximately .2 mm) and super translucent. Traditional veneers are fused or bonded to teeth, and generally the Dentist will need to grind down the tooth for a good fit. Since Lumineers is so thin, little to no tooth reduction is necessary. In addition, Lumineers resists micro-leakage and micro-cracking. Click here for detailed information and video.

No. Lumineers can only be made from patented Cerinate porcelain. This revolutionary porcelain is crafted through a proprietary process unavailable anywhere other than Den-Mat Holdings, LLC, one of the nation's largest manufacturers of professional dental materials. Click here for detailed information and video.

In most cases no. It is true that most veneer procedures require a substantial amount of tooth structure removal, and there is pain and discomfort involved. Lumineers is completely different because there is no need for grinding, cutting or filing of teeth in almost all cases. Consequently, no anesthetic or numbing shots are needed. Plus, no uncomfortable temporaries are required while you wait for Lumineers to be created. Once the procedure is completed, there is no post-placement discomfort or sensitivity, which means Lumineers will look natural and feel comfortable from the start. Click here for detailed information and video.

In most cases, yes. The Dentist will be able to evaluate your teeth and decide whether orthodontics is necessary. If you do not have a severe problem, Lumineers will change the shape and alignment of teeth, making them look straighter and more uniform. Click here for detailed information and video.

Lumineers has unparalleled longevity. Clinical testing has proven that a Lumineers procedure lasts and looks great for 20 years and beyond. Lumineers by Cerinate also offers a 5-year Warranty and are replaced at no charge. Certain restrictions do apply. Click here for detailed information and video.

Yes, Lumineers are completely reversible. This is largely due to the no reduction in sensitive tooth structure so that the natural teeth are still in tact and strong. Click here for detailed information and video.

There are no limitations to what you can eat or drink as Lumineers are placed over original teeth in the most durable way possible. However, you should continue to visit your dentist at least every 6 months for a check-up and cleaning to keep your Lumineers in good condition and to qualify for the Warranty. Click here for detailed information and video.

More than 5,000 Dentists nationwide use Lumineers by Cerinate and we continue to educate the dental community on this new procedure. Recently, a national advertising campaign has been launched to educate consumers about this noninvasive technique. Click here for detailed information and video.

Malocclusion is the technical term for teeth that don't fit together correctly. See Orthodontics - What is a malocclusion?

Mercury Free refers to not using mercury silver amalgam fillings. Mercury Safe refers to the safe removal of mercury silver amalgam fillings. The mercury free dentists of the world have been acutely aware of the potential for excess exposure to mercury when removing amalgam fillings, and have devised a number of strategies for reducing the amount of mercury exposure to both patients and dental staff during amalgam removal. We follow the protocol of the IAOMT for safe mercury removal. Click here for detailed information and video.

See Fillings - Are Mercury Silver Amalgam fillings safe?

See Chipped Teeth

With many state-of-the-art dental treatments and prevention options available in dentistry today, there are fewer reasons for having to extract (remove) teeth. When something does go wrong with a tooth, we try to do everything possible to restore the tooth to its original function. Removing a tooth is the last option because we know that removal may lead to severe and costly dental and cosmetic problems if the tooth is not replaced.

Losing a tooth can be a very traumatic experience and it's very unfortunate when it does happen.  Injury, accident, fracture, severe dental decay, and gum disease are the major reasons for having to remove a tooth.  If teeth are lost due to injury or have to be removed, it is imperative that they be replaced to avoid cosmetic and dental problems in the future.

When a tooth is lost, the jaw bone that helped to support that tooth begins to atrophy, causing the teeth on either side to shift or tip into the open space of the lost tooth.  Also, the tooth above or below the open space will start to move towards the open space because there is no opposing tooth to bite on.  These movements may create problems such as decay, gum disease, excessive wear on certain teeth, and TMJ (jaw joint) problems.  These problems and movements do not result immediately, but will eventually appear, compromising your chewing abilities, the health of your bite, and the beauty of your smile.

Options for replacement of missing teeth

Removable bridges - This type of bridge is a good solution for replacing one or more missing teeth, especially in complex dental situations where other replacement options are not possible. They are usually made of tooth-colored, artificial teeth combined with metal clasps that hook onto adjacent natural teeth. Removable bridges are the most economical option for replacing missing teeth, but may be the least aesthetically pleasing. This is because the metal clasps on the appliances are often impossible to completely conceal.

Fixed bridges - This type of bridge is generally made of porcelain or composite material and is anchored (cemented) permanently to a natural teeth adjacent to the missing tooth site. The benefit of this type of bridge is that it is fixed (not removable) and it is very sturdy. The disadvantage is that in order to create a fixed appliance, two healthy, natural teeth will have to be crowned (capped) to hold the bridge in place.

Dentures - This type of tooth replacement is used when most or all of the natural teeth are missing in one dental arch. Dentures are removable artificial teeth that are made to closely resemble the patients' original teeth.

Implants - Are a great way to replace one or more missing teeth. They may also be great to support ill fitting dentures. A dental implant is an artificial root that is surgically placed into the jaw bone to replace a missing tooth. An artificial tooth is placed on the implant, giving the appearance and feel of a natural tooth. Implants are very stable, durable, and are the most aesthetically pleasing tooth replacement option.

If you are missing teeth, ask us if they need replacement and what options are available to you. Together we will select the best replacement option for your particular case. Prevention and early treatment is always less involved and less costly than delaying treatment and allowing a serious problem to develop.

See Bruxism - What is a night guard?

See Hydroflossing

Following are just some of the many examples of common oral surgeries:

• TMJ
• Facial Pain
• Facial Reconstruction
• Dental Implants
• Tooth Extractions & Impacted Teeth
• Wisdom Teeth
• Misaligned Jaws
• Cleft Lip & Palate
• Apicoectomy
• Oral Cancers, Tumors, Cysts, & Biopsies
• Sleep Apnea
• Facial Cosmetic Surgery

Click here for detailed information and video.

See Tongue Piercing

A malocclusion is an incorrect relationship between the maxilla (upper arch) and the mandible (lower arch), or a general misalignment of the teeth. Malocclusions are so common that most individuals experience one, to some degree. The poor alignment of the teeth is thought to be a result of genetic factors combined with poor oral habits, or other factors in the early years. Click here for detailed information and video.

Crossbite is an occlusal irregularity where a tooth (or teeth) has a more buccal or lingual position (that is, the tooth is either closer to the cheek or to the tongue) than its corresponding antagonist tooth in the upper or lower arcade. Click here for detailed information and video.

An overbite refers to the protrusion of the maxilla (upper jaw) relative to the mandible (lower jaw). An overbite gives the smile a toothy appearance and the chin looks like it has receded. Click here for detailed information and video.

An underbite, also known as a negative underjet, refers to the protrusion of the mandible (lower jaw) in relation to the maxilla (upper jaw). An underbite makes the chin look overly prominent. Developmental delays and genetic factors generally cause underbites and overbites. Click here for detailed information and video.

Retainers are removable devices that are generally used to hold the teeth in the correct position while the jawbone grows properly around them. Click here for detailed information and video.

Braces are most desirable for people under the age of 18.  At this stage in life, the bone is more malleable, teeth move easier and are more likely to stay once the bone "remodels" around the newly positioned teeth. Many adults also wear braces, but for a longer duration and almost always need a permanent retainer to hold the new positioning. There are numerous office visits in addition to the general hassles of wearing braces. Also, teeth may be repositioned, but continue to be the same shape and color which may or may not be desirable. Orthodontic braces, however, do not require the teeth to be reshaped or restructured in any way.

Sometimes called, "instant-ortho", veneers can give the appearance of straightening teeth, closing gaps, and changing the shape of teeth to give a perfect smile. A veneer is a thin shell of porcelain. After the enamel on teeth are reduced, usually only slightly, the veneers are bonded in place covering the visible part of a tooth. Seated correctly, they are strong and should last a very long time. The bite is most often enhanced and veneers do not stain or discolor.

The Invisalign® system is the virtually invisible way to straighten your teeth and achieve the smile you've always dreamed of. Using advanced 3-D computer-imaging technology, Invisalign depicts your complete treatment plan, from the initial position of your teeth to the final desired position. Then a series of clear aligners are custom-made for your teeth – and your teeth only – to move them little by little. Each aligner is worn for about two weeks before being replaced by the next in the series, until the final position of your teeth is achieved. Your Invisalign treatment time will be determined by your doctor, based on your specific needs. Click here for detailed information and video.

Invisalign aligners are practically clear. No one may even notice that you're wearing these virtually invisible "braces," making Invisalign a seamless fit with your lifestyle and day-to-day interactions with others.

Invisalign is removable. Unlike braces, you have the flexibility to eat and drink what you want during treatment by simply removing the aligners. And you can also remove the aligners to brush and floss as you normally would for fresh breath and good oral hygiene.

Unlike braces, there are no metal brackets or wires with the Invisalign system that could cause irritation to your mouth. Plus since your office visits during treatment don't involve metal or wire adjustments, you'll likely spend less time in the doctor's chair.

And finally, Invisalign allows you to view your virtual results and treatment plan before you start so you can see how your straight teeth will look when your treatment is complete.

More than 1,000,000 patients worldwide have been treated with Invisalign. The number of Invisalign smiles grows daily.

It's simple, just make an appointment with an Invisalign Preferred Provider for an initial consultation. Many doctors offer free initial consultations. For the best experience, take the time to find the "right" doctor — one who you feel comfortable with and who has experience treating cases like yours. Like with other important dental decisions, sometimes it is worthwhile to seek out a second or even third opinion. Use our Find-A-Doctor feature to find the most experienced Invisalign-trained doctor near you. Doctors designated as Premier Providers have a greater levels of case experience. Those labeled Premier Provider Elite have the highest levels of case experience. Make sure you trust your smile to an experienced doctor who uses the latest techniques.

All dentists interested in treating patients with Invisalign must attend and complete specialized instructional sessions to become trained Invisalign providers. In addition, doctors must maintain regular treatment submission and have complete ongoing clinical training classes to earn the designation "Preferred Provider."

Like brackets and arch wires are to braces, Invisalign aligners move teeth through the appropriate placement of controlled force on your teeth. The main difference is that Invisalign not only controls forces, but also the timing of the force application. During each stage, only certain teeth are allowed to move. These movements are determined by your doctor as he or she maps out your unique Invisalign treatment plan.

The virtually invisible aligners, which are made of a thermoplastic material uniquely developed for the Invisalign treatment plan, look similar to tooth-whitening trays. Invisalign aligners are custom-made for you and only you to move your teeth in the sequence determined by your doctor.

No. Invisalign aligners and Vivera Retainers do not contain Bisphenol-A or phthalate plasticizers. These aligners and retainers are made with USP Class VI medical grade, high molecular weight, polyurethane resins. Tests have been conducted to determine the biocompatibility of these materials, and show that they are biocompatible and pass all applicable regulatory requirements and thresholds for human wear in the mouth. Of course, as with any medical device, you should consult with your health professional about your aligner or retainer treatment and any applicable risks of use.

A number of Invisalign patients have undergone a previous treatment involving braces at some point in their past, often during their youth. Invisalign can usually correct the shifting that occurs after braces, and do so without having to go through the trauma and social awkwardness of wearing metal braces.

Doctors are treating a significant number of patients with a combination of braces and Invisalign. Consult your Invisalign doctor to determine the best treatment for you.

Similar to other orthodontic treatments, Invisalign aligners may temporarily affect the speech of some people, and you may have a slight lisp for a day or two. However, as your tongue gets used to having aligners in your mouth, any lisp caused by the aligners should disappear.

No. Thanks to the removable nature of the aligners, you can eat and drink whatever you want while in treatment. In fact, you're required to remove your aligners to eat and drink. So, unlike undergoing traditional treatment using wires and brackets, there is no need to restrict your consumption of any of your favorite foods and snacks unless instructed otherwise by your doctor. Also, it is important that you brush your teeth after each meal and prior to re-inserting your aligners to maintain fresh breath and proper hygiene.

We discourage smoking while wearing aligners because it is possible for the aligners to become discolored.

No, gum will stick to the aligners. We recommend removing your aligners for all meals and snacks.

While Invisalign moves your teeth without the pain and anxiety of metal braces, some people will experience temporary discomfort for a few days at the beginning of each new stage of treatment. This is normal and is typically described as a feeling of pressure. It's also a sign that Invisalign is working, as it moves your teeth to their final destination. This discomfort typically goes away in a couple of days.

The best way to clean your aligners is to use the Invisalign cleaning kit, available for order at www.invisalignstore.com. As a secondary method, however, your aligners can also be cleaned by brushing them and rinsing them in lukewarm water.

We find aligners are most effective if worn 20 to 22 hours per day – and removed only for eating, brushing, and flossing.

Your doctor will schedule regular appointments – usually about once every four to six weeks. The goal of these visits are to ensure that your treatment is progressing as planned.

Align Technology, Inc., the company that manufactures Invisalign, was founded in 1997.

Invisalign aligners are classified as Class II medical devices by the FDA, and Align Technology, Inc.has held the necessary 510K clearance from the FDA since 1998 to be able to sell and market the Invisalign system.

Invisalign Teen is appropriate for patients who have shed all of their baby teeth and have second molars at least partially erupted – this includes most teens. Ask your orthodontist if you qualify to start treatment now.

The length of treatment depends on the severity of your case and can only be determined by your doctor; however the average case takes about 12 months.

This varies person to person and depends on the outcome of the treatment. Some patients might need a positioner, or conventional retainer. Other patients might need a clear plastic retainer similar to the ones Invisalign makes, such as Align Technology's Vivera Retainer, (www.viveraretainer.com). Discuss this with your dentist. Every patient is different, and outcomes vary.

We know cost is a big question for anyone considering orthodontic work. Similar to other medical treatments, only your doctor can determine the cost based on your specific needs. Other factors could include what you want corrected or the difficulty of your case, how long you are in treatment, where you live, your orthodontic insurance coverage, and additional factors determined by your dentist or orthodontist. In most cases, Invisalign treatment is comparable to the cost of traditional braces. In the U.S., the cost of Invisalign treatment ranges from $3,500 to $8,000, with the national average at about $5,000.

Because medical benefits differ significantly from policy to policy, you should review your personal coverage plan. However, in general, if a patient has orthodontic coverage, Invisalign should be covered to the same extent as conventional braces.

Click here for detailed financing options.

See Orthodontics - What is an Overbite?

The Caesy Dental Education System helps us educate patients though multimedia modules showing cosmetic and general dental topics. Most of our procedures on our website are illustrated using these excellent educational videos. We also use these in our office to explain and illustrate the details of various procedures.

Four out of five people have periodontal disease and don't know it!  Most people are not aware of it because the disease is usually painless in the early stages.  Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms.  Having regular dental check-ups and periodontal examinations are very important and will help detect if periodontal problems exist.

Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums.  The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone.  Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.

Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:

• Smoking or chewing tobacco - Tobacco users are more likely than nonusers to form plaque and tartar on their teeth.
• Certain tooth or appliance conditions - Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.
• Many medications - Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives.  Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.
• Pregnancy, oral contraceptives and puberty - Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.
• Systemic diseases - Diabetes, blood cell disorders, HIV / AIDS, etc.
• Genetics may play role - Some patients may be predisposed to a more aggressive type of periodontitis.  Patients with a family history of tooth loss should pay particular attention to their gums.

Signs and Symptoms of Periodontal Disease

• Red and puffy gums - Gums should never be red or swollen.
• Bleeding gums - Gums should never bleed, even when you brush vigorously or use dental floss.
• Persistent bad breath - Caused by bacteria in the mouth.
• New spacing between teeth - Caused by bone loss.
• Loose teeth - Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
• Pus around the teeth and gums - Sign that there is an infection present.
• Receding gums - Loss of gum around a tooth.
• Tenderness or discomfort - Plaque, calculus and bacteria irritate the gums and teeth.

Good oral hygiene, a balanced diet and regular dental visits can help reduce your risk of developing periodontal disease. Click here for detailed information and video.

Periodontal disease can re-activate, as periodontal bacterial colonies begin to rebuild every 50–75 days. If you are diagnosed with periodontal disease, you need ongoing periodontal maintenance cleanings at least 4 times a year to prevent further bone loss and subsequent tooth loss. Click here for detailed information and video.

See Tongue Piercing

See Veneers

Prosthodontics is one of the 9 officially recognized dental specialties offering dentures, bridges and the restoration of implants. Some prosthodontists further their training in "oral and maxillofacial prosthodontics", a discipline concerned with the replacement of missing facial structures such as ears, eyes, nose, etc.

The upper and lower dental arches are divided into a right and a left quadrant. The quadrants are formed by an imaginary line called the midline that passes between the two front middle teeth in each arch and divides the arch in half. There are four quadrants in the mouth.

Tooth reshaping, or contouring, is one of few "instant" treatments now available in cosmetic dentistry. Dental reshaping and contouring is a procedure that can aesthetically improve certain crooked teeth, chipped teeth, cracked teeth or even overlapping teeth in just one session. Tooth reshaping and dental contouring, is commonly used to alter the length, shape or position of your teeth. Contouring teeth may also help correct small problems with bite. It is common for bonding to be combined with tooth reshaping.

This procedure is ideal for candidates with normal healthy teeth, but who want subtle changes to their smile. The dental contouring procedure can even be a substitute for braces under certain circumstances. It is also a procedure of subtle changes. A few millimeters of reduction and a few millimeters of tooth colored veneer can create a beautiful smile when performed by a cosmetic dentist, with no discomfort to you.

If you want your teeth to appear less crowded, lack chips and fractures, have decreased overlaps or to be without pits or grooves in the enamel, this procedure should be discussed with your cosmetic dentist. With a little dental contouring, you can make a huge difference in the way you feel about your smile. Good cosmetic dentistry can give you a smile that is the envy of others.

Tooth contouring by a cosmetic dentist does require that you have normal, healthy teeth. Done right, tooth reshaping, or tooth sculpting, is a safe and conservative way top improve your smile. Teeth may become weaker if large amounts of enamel are removed, tooth reshaping should be limited to minor changes or combined with veneers or bonding for the best smile.

Preparation for dental reshaping and contouring is a team effort. Our cosmetic dentists even use computer imaging to show you how you will look after the procedure. We will usually mark your teeth with a pen prior to performing the procedure. This helps us in the sculpting process. As our cosmetic dentist sculpts the tooth, imperfections are artfully eliminated or minimized. A sanding drill may be used to remove small amounts of surface enamel gradually. Abrasive strips are then moved back and forth between your teeth to shape the actual sides of your teeth. Then the teeth are smoothed and polished. Usually anesthetic is not needed. Teeth contouring and reshaping usually can be done in one visit.

A badly infected tooth or one that just had significant decay can sometimes be salvaged through procedures utilized by both the general dentist and the root canal specialist, the endodontist. Extraction is truly our last resort. Click here for more detailed information and video.

Some indications of the need for root canal treatment may be: Spontaneous pain or throbbing while biting; Sensitivity to hot and cold foods; Severe decay or an injury that creates an abscess (infection) in the bone. Click here for more detailed information and video.

Losing a tooth can precipitate further teeth loss. Saving the tooth maintains space, keeps other teeth from shifting, and eliminates the need and cost of a bridge or implant and crown. Although seemingly expensive, it is actually quite cost effective. Remember, once your teeth are gone, they're gone! Click here for more detailed information and video.

A root canal is really not as bad as it is sometimes made out to be and in our office, we try to make it as pleasant as possible. Here's how it works. Root canal treatment consists of the removal of the infected or irritated nerve tissue that lies within the root of the tooth. It is this infected pulp tissue that causes an eventual abscess.

The first step in a root canal is to obtain access to the nerve. This is accomplished by establishing a small access opening in the top of the tooth. It will be done under a local anesthetic. The length of the root canals is determined and the infected pulp is removed.

Usually at the same visit, the canal where the nerve is located will be reshaped and prepared to accept a special root canal filling material. This filling procedure will probably not occur until your next visit. The number of visits necessary to complete your root canal will depend upon several factors including the number of nerves in the tooth, the infected state of the nerve and the complexity of the procedure. The final step in your root will be sealing of the root canal with a sterile, plastic material, called gutta percha. This is done in order to prevent possible future infection.

The tooth will then possibly need a post and core and a crown in order to re-establish normal form and function. This decision will based upon several additional factors. If treated early, root canal therapy need not be uncomfortable.

Another "Old Wives Tale" is that by removing the nerve the tooth becomes "dead". This is not true. The tooth is very much alive and functioning because it receives a source of blood supply and nerve feeling too hot, cold or sweets but will be responsive to biting pressures etc. With the proper restoration the tooth should last, as long as your other teeth and can even be used as an anchor tooth for a partial denture or cemented bridge.

Sometimes when there has been long-standing infection or abscess, there may be some soreness associated with the first or second root canal visit. If this should be true, you will be given specific instructions to follow to minimize the discomfort. When an infection is present, it may be necessary to take an antibiotic. If pain should be present, analgesics may need to be prescribed. In either case, be sure to call your dental office if either of these problems should arise.

Click here for more detailed information and video.

See Chipped Teeth

With Sapphire (also known as Lumibrite) Teeth Whitening, you can bid farewell to sensitivity, the most common patient complaint about whitening. Not even a pre-treatment aspirin is needed when you use this breakthrough chairside formula. For beautiful, white smiles when you want immediate results.

SAPPHIRE allows you to achieve dramatic results quickly. When used with the Sapphire Supreme Light*, the system is proven to whiten smiles up to 8 shades in only 30 minutes. SAPPHIRE also allows you the flexibility to whiten your smile without light activation.

*With the Sapphire whitening lights, you can also say goodbye to complicated setup. Unlike other lights, Sapphire does not expose you to harmful UV rays and, thus, does not require you to wear sunscreen or a face mask. Click here for detailed information and video.

Carbamide peroxide is approximately 1/3 of the strength of hydrogen peroxide. The Professional Take-Home Kits are a carbamide formulation. The Professional Chairside kits are hydrogen peroxide. Click here for detailed information and video.

When peroxide breaks down (either on its own, or accelerated with a light) it forms oxygen bubbles that get down into the microscopic pores of the tooth to clean out stains. Click here for detailed information and video.

Intrinsic stains (stains inside the tooth, often caused by medications) are more difficult to whiten than extrinsic stains (surface stains, generally caused by smoking, coffee, red wine, etc.). However, good whitening results can be achieved with either system. Lengthier whitening sessions, higher concentrations of peroxide, or multiple treatments will help to achieve better results. Each patient is different and results will vary. If whitening does not produce the desired results, LUMINEERS porcelain veneers may be a better option. Click here for detailed information and video.

Each patient is different. There is not a way to determine before the procedure what type of shade change will result. Each patient should be informed of this before treatment begins. Click here for detailed information and video.

The Professional Take-Home kits are available in 16%, 22% and 32% Carbamide peroxide formulations. The Professional Chairside Kits are a 35% Hydrogen peroxide formulation.

The Professional Chairside Kits may be used with or without a light. However, we recommend the Sapphire Plasma Arc Light. Achieve over a 7 shade change in 30 minutes or up to a 12 shade change in an hour! Click here for detailed information and video.

The objective of scaling & root planning is to remove etiologic agents which cause inflammation to the gingival (gum) tissue and surrounding bone. Common etiologic agents removed by this conventional periodontal therapy include dental plaque and tartar (calculus). These non-surgical procedures which completely cleanse the periodontium, work very effectively for individuals suffering from gingivitis (mild gum inflammation) and moderate/severe periodontal disease. Click here for detailed information and video.

Although thorough brushing and flossing remove most food particles and bacteria from easy to reach tooth surfaces, they do not reach the deep grooves on chewing surfaces of teeth. More than 75 percent of dental decay begins in these deep grooves (called pits and fissures). Toothbrush bristles are too large to possibly fit and clean most of these areas. This is where sealants play an important role.

A sealant is a thin plastic coating that covers and protects the chewing surfaces of molars, premolars and any deep grooves or pits on teeth. Sealant material forms a protective, smooth barrier covering natural depressions and grooves in the teeth, making it much easier to clean and help keep these areas free of decay.

Who may need sealants?

Children and teenagers - As soon as the six-year molars (the first permanent back teeth) appear or any time throughout the cavity prone years of 6-16.

Infants - Baby teeth are occasionally sealed if the teeth have deep grooves and the child is cavity prone.

Adults - Tooth surfaces without decay that have deep grooves or depressions that are difficult to clean.

Sealants are easily applied by your dentist or dental hygienist and the process only takes minutes per tooth. After the chewing surfaces are roughened with an acid solution that helps the sealant adhere to the tooth, the sealant material is "painted" onto the tooth surface, where it hardens and bonds to the teeth. Sometimes a special light will be used to help the sealant material harden.

After sealant treatment, it's important to avoid chewing on ice cubes, hard candy, popcorn kernels, or any hard or sticky foods. Your sealants will be checked for wear and chipping at your regular dental check-up.

Combined with good home care, a proper diet, and regular dental check-ups, sealants are very effective in helping prevent tooth decay.

Sedation dentistry refers to the use of pharmacological agents to calm and relax a patient prior to and during a dental appointment. The pharmacological agents usually belong to a class of drugs called sedatives, which exert their action by depressing the central nervous system, specifically those areas concerned with conscious awareness.

There are different degrees of central nervous system depression, each corresponding to a level of relaxation which ranges from minimal, moderate, to deep sedation. In general, minimal sedation refers to a patient who has reduced anxiety, but readily responds to verbal or physical stimulation. With moderate sedation the patient is even more relaxed, and will respond to purposeful stimulation. In deep sedation, the patient may not exhibit any signs of consciousness and therefore be unresponsive to stimulation.

Sedation by pharmacologic methods may be obtained by two general routes. The Enteral route includes medications that are either swallowed, absorbed through the mucosa of the oral cavity, or inserted rectally. The Parenteral route involves the administration of sedative drugs other than absorption within the alimentary canal. These methods include intravenous, inhalation, intramuscular, and submucosal administration, among others. Click here for detailed information and video.

One of the most common problems in dentistry is sensitive teeth. There are many possible causes, including improper stresses on teeth, loss of the tooth's protective enamel layer, and occasionally some dental procedures.

One of the major sources of improper stresses is the unconscious habit of grinding and clenching the teeth. Another source of stress occurs when teeth do not come together properly. Some teeth always hit sooner than the rest, and they become sensitive.

Teeth also become sensitive when they lose their protective outer layer that exposes the dentin. The dentin is the middle layer of the tooth, and it is normally protected by enamel (above the gumline) and cementum (below the gumline). Dentin contains millions of tiny tubes that extend from the nerves at the center of the tooth to the outer layer. When the dentin is exposed, these tubes are left open. Any stimulation at the surface of the dentin is transmitted through the tubes to the nerves, causing pain.

The dentin can become exposed through various processes, such as abfraction, erosion and abrasion. Abfraction occurs when one tooth hits sooner than the rest, causing the tooth to flex. Over time, this continual flexing causes the enamel to separate from the dentin.

Erosion occurs when acids dissolve the enamel. This is often caused by the frequent sipping of acidic soft and sports drinks or exposing the teeth to stomach acids through acid reflux disease or bulimia.

Abrasion takes place when the protective layer is worn away. This can happen when you brush too hard, use a medium or hard-bristled toothbrush, or use an abrasive "tartar-control" or "whitening" toothpaste. Lastly, some dental procedures, such as bleaching and placing restorations, may sometimes lead to short-term sensitivity.

Diagnosis and Treatment

To determine the cause of your tooth pain, we do a thorough examination. Then we perform the most appropriate treatment for the situation.

Short-term sensitivity can often be handled by using a desensitizing toothpaste or mouthwash.

If the problem is improper stress on teeth, we may adjust your bite or recommend that you wear a mouthguard. If the problem is exposed dentin, we may present a plan for improved brushing techniques, counsel you about your diet, or apply a protective coating, bonding agent or restoration.

See Fillings - Are mercury silver amalgam fillings safe?

There are a number of options including porcelain veneers, crowns and bonding.

No. Each person is different and each case is different, and has to be planned very carefully. There are many differences between male and female teeth and between all people. The design of the teeth has to be in proportion with the gum line, the lips, and the construction of the face of each individual to achieve a beautiful and natural smile.

In many cases, the answer is, "yes". If you have teeth that are worn, shifted, missing, broken, or a combination of these, then Full Mouth Restoration may be the answer. It is designed to restore your smile and at the same time, make eating easier and more comfortable. Cosmetic dentistry has evolved dramatically in recent years. Many people have old dentistry that was done in bits and pieces. Much of it has worn resulting in collapsed bites and difficulty with chewing. This patchwork quilt of old dental work creates an appearance that can age you beyond how you feel. Furthermore, a poor bite can cause jaw joint problems, muscle tenderness, and even headaches. Chewing and speech may be affected as well.

The first thing we do is listen –- to what your desires are for your smile. We then can perform computerized cosmetic imaging. We simply take a number of photos showing different views of your face with a digital camera. We then use graphic artist software to generate a computerized image showing you with various smile enhancements. We work with you to determine things like how white you would like your smile, the shape of your teeth, and other aspects of your smile. Cosmetic imaging, although an artificial rendering, can assist in giving you a better idea of what you can look like after cosmetic dental improvements. We also may want to have our in-house dental lab perform a "wax-up" of your new smile, which would show in life-like, tangible form the proposed treatment.

Smile Design is the primary service the Four Seasons Dental & Med Spa offers. Smile Design is a highly technical process requiring great skill and experience to achieve a natural result. It is not taught at all or only touched upon in dental school – dentists mush learn the techniques in post graduate courses and then perfect the art through extensive experience. For this reason, most dentists do not focus on this discipline.

It takes artistic ability and extensive knowledge to perform an impeccable Smile Design. Techniques require precise measurements based upon mouth shape, gum lines, lips, and natural shape of the teeth. That's why we devote time to precisely planning a Smile Design before we begin the actual procedure.

During a patient's initial cosmetic consultation, our team can download a digital photograph into an imaging program and show the guest what their new smile can look like. Extensive Smile Design treatments may require as few as two appointments that are typically several hours each depending on the complexity.

We utilize special hardware and software to illustrate the potential end results of a complete Smile Makeover. Patients are invited to "try-on" their new smile before the smile design process begins.

By now almost everyone knows that smoking has been linked with lung disease, cancer and heart disease. But most people are not aware that smokers are three to six times more likely to have periodontal disease, and two times more likely to lose teeth. Click here for detailed information and video.

Snap-On Smile is a multi-purpose restorative appliance that simply snaps in and out over patients' natural teeth. Made of very thin, but extremely strong, specialized resin that resists staining, Snap-On Smile can be used for years or worn as a preview and covering over ongoing dental restorations. It should never come loose or fall out. The customized appliance is available for upper and lower teeth and is easy to care for with a special Snap-On Smile Care Kit that comes with your Snap-On Smile appliance. Click here for detailed information and video.

Sleep apnea is a sleep disorder characterized by having one or more pauses in breathing or shallow breaths during sleep. Each pause in breathing, called an apnea, can last from a few seconds to minutes, and may occur 5 to 30 times or more an hour. Sleep apnea is diagnosed with an overnight sleep test called a polysomnogram, or a "sleep study". Click here for detailed information and video.

For many people, soft drinks are the beverage of choice. But if you drink them all day long, you may not realize the damage you can be doing to your teeth. Click here for detailed information and video.

Discoloration occurs in the enamel and can be caused by medication, coffee, tea and cigarettes. Discoloration also can be caused by your genetic make-up or simply getting older.

See Discoloration - How can I correct severely discolored teeth caused by Tetracycline?

Tempro-Mandibular Joint Dysfunction (TMD or TMJ) is a common condition affecting a wide variety of people. TMD is characterized by severe headaches, jaw pain of varying degrees, grinding teeth, and an intermittent ringing in the ears. The vast majority of TMD sufferers are unaware that the root cause of these problems is something that a dentist can effectively treat.

The symptoms of TMD are debilitating and can greatly interfere with every day life. The comfort and general well being of the patient is at the heart of the dental practice, so pain relief is the first consideration of the dentist. The dentist is able to test, diagnose, and devise an immediate plan to treat the underlying causes of the TMD disorder. Click here for detailed information and video.

Many people want to get their tongue or lips pierced. This is not the same as getting your ears pierced. Unlike your ear lobe, your tongue is a muscle that has many blood vessels and nerves. Because your tongue is covered with bacteria, they can invade the open wound and enter your bloodstream. This can result in painful infections that ooze pus into your mouth and throat. If this happens, you need to get immediate medical attention.

The needle used to pierce the tongue is quite thick. If it hits one of the many veins in your tongue, you can expect to have heavy bleeding. The needle can also sever a nerve in the tongue, which can result in permanent numbness.

The jewelry itself can present problems. The hard metal ball is constantly hitting the fragile tooth structure, much like a wrecking ball. People with tongue studs tend to habitually bite them, which increases the chance of chipping or scratching a tooth. Lip rings can also wear away the gums. This can lead to gingivitis and expose the tooth roots, which can make your teeth sensitive to hot, cold and sweet foods.

We do not advocate it, but if you must get an oral piercing, take some precautions. Click here for detailed information and video.

We're all at risk for having a tooth knocked out.  More than 5 million teeth are knocked out every year!  If we know how to handle this emergency situation, we may be able to actually save the tooth.  Teeth that are knocked out may be possibly reimplanted if we act quickly, yet calmly, and follow these simple steps:

• Locate the tooth and handle it only by the crown (the chewing surface of the tooth), NOT by the roots.
• DO NOT scrub or use soap or chemicals to clean the tooth.  If it has dirt or debris on it, rinse it gently with your own saliva or whole milk.  If that is not possible, rinse it very gently with water.
• Get to a dentist within 30 minutes.  The longer you wait, the less chance there is for successful reimplantation.

Ways to transport the tooth

• Try to replace the tooth back in its socket immediately.  Gently bite down on gauze, a wet tea bag or on your own teeth to keep the tooth in place.  Apply a cold compress to the mouth for pain and swelling as needed.
• If the tooth cannot be placed back into the socket, place the tooth in a container and cover with a small amount of your saliva or whole milk.  You can also place the tooth under your tongue or between your lower lip and gums.  Keep the tooth moist at all times.  Do not transport the tooth in a tissue or cloth.
• Consider buying a "Save-A-Tooth" storage container and keeping it as part of your home first aid kit.  The kit is available in many pharmacies and contains a travel case and fluid solution for easy tooth transport.

The sooner the tooth is replaced back into the socket, the greater the likelihood it has to survive and possibly last for many years.  So be prepared, and remember these simple steps for saving a knocked-out tooth.

You can prevent broken or knocked-out teeth by:

• Wearing a mouthguard when playing sports
• Always wearing your seatbelt
• Avoiding fights
• Avoid chewing hard items such as ice, popcorn kernels, hard breads, etc.

See Orthodontics - What is an Underbite?

Cosmetic contouring, porcelain veneers, orthodontics, bonding or crowns can be used to correct this. We usually recommend porcelain veneers to get the best aesthetic results. The best way to determine the best option for you is through a cosmetic consultation, and we have a couple of ways to do them.

One option is that we can do just a smile analysis, but this has its pros and cons. Essentially what we do is perform a "look see" to see what the general situation is with your smile and our first impressions of what may work for you, whether it be whitening, bonding, veneers, etc.

The second option, and our recommended approach, is our more detailed cosmetic consultation. This consult comes after we perform a full exam, x-rays, cleaning and a number of other diagnostic procedures. At that point, through computerized cosmetic imaging, we can develop a customized smile design that is very detailed and specific for you. It may take 2 visits for the detailed cosmetic initial exam, full series of x-rays, cleaning and imaging.

See Cancer Screening

See Orthodontics Braces vs. Veneers - What are the pros and cons of Braces vs. Veneers?

See Lumineers - How are Lumineers™ different than traditional veneers?

Veneers are formed porcelain shells that are used to create a new front surface to a tooth. These are thin sculpted pieces of tooth-shaped porcelain that fit over the front of the teeth and are the premier standard of care in cosmetic dentistry. Permanently bonded to the front surface of a tooth, to restore or improve position, shape and tooth color, they can make a dramatic immediate difference to one's smile and overall facial appearance. Veneers are wonderful for fixing common problems such as midline spaces (the gap-toothed look of the two front upper teeth) or chipped, crooked, missing, discolored, pitted, malformed or improperly positioned teeth. Once only accessible to the wealthy and top Hollywood stars and models, veneers are now a popular way for many people to obtain the smile of their dreams.

Veneers may be used to restore or correct the following dental conditions:

• Severely discolored or stained teeth
• Unwanted or uneven spaces
• Worn or chipped teeth
• Slight tooth crowding
• Misshapen teeth
• Teeth that are too small or large

Getting veneers usually requires two visits.  Veneers are created from an impression (mold) of your teeth that is then sent to a professional dental laboratory where each veneer is custom-made (for shape and color) for your individual smile.

With little or no anesthesia, teeth are prepared by lightly buffing and shaping the front surface of the teeth to allow for the small thickness of veneers.  The veneers are carefully fitted and bonded onto the tooth surface with special bonding cements and occasionally a specialized light may be used to harden and set the bond.

Veneers are an excellent dental treatment that can dramatically improve your teeth and give you a natural, beautiful smile. Click here for detailed information and video.

A composite bonding (also sometimes called "direct veneers" or "plastic veneers") is a tooth-colored plastic resin material. Bonding can usually be placed in one visit and is used many times to repair a smaller chip in a tooth or to make aesthetic improvements in more than one tooth. Bonding usually requires little to no tooth reduction or anesthesia. Because they are made out of porcelain in a lab, porcelain veneers are usually more aesthetic in terms of the spectrum of colors, realism and translucency. Porcelain veneers are also more of a long-term solution than bonding, as they do not stain, discolor, and are stronger than bonding. Porcelain veneers usually require two office visits: (1) the first visit to prepare the teeth; (2) the second to seat the veneer. Click here for detailed information and video.

Veneers are made from a thin shell of porcelain and are permanently bonded to the teeth. Our selected, world-class dental ceramists fabricate the veneers from our impressions and color mapping specifications. Each veneer is custom-designed to fit naturally and comfortably over each tooth like a ballet slipper. After placement, these veneers are designed to look like beautiful, natural teeth. Click here for detailed information and video.

Unlike crowns, usually only a thin layer of enamel is removed from the teeth to make room for the veneers. Usually, only about 5/10 to 8/10 of a millimeter is removed from the outer surface. This small amount of reduction is required to make room for the porcelain. This allows us to make the veneers to the proper contour without them appearing to be bulky or unnatural. Some teeth on some individuals may not need any tooth reduction, and some may require a lot. Click here for detailed information and video.

New advances in bonding technology allow us to create an extremely strong bond between your teeth and the veneers. The teeth are first prepared with a bonding adhesive, and a special resin cement is used as the "glue". The resin cement is available in a number of different colors to give the best possible aesthetic result. After approval, resins are then used to permanently bond the veneers to the teeth using a special dental curing light, which helps to create a stronger, longer-lasting bond between the veneer and your tooth. The durability, look and simplicity of application make it easy to see why veneers have become one of the most popular cosmetic dental treatments available today. Click here for detailed information and video.

Some people experience sensitivity (to hot and cold or pressure, etc.) after the placement of veneers. Some sensitivity is absolutely normal and usually dissipates spontaneously from a day or so to a couple of weeks. The reason for the sensitivity can arise from the amount of enamel left on your tooth after preparation, the proximity of the nerve, as well as several other factors. If this sensitivity remains or concerns you at all, please contact the doctor.

With proper home care and scheduled dental visits, veneers can provide you with a beautiful smile for many years. A week or two after the placement of your veneers, we ask that you return to our office for a cosmetic polish and treatment evaluation. This visit is extremely important. It gives us the opportunity to evaluate the placement of the veneers, the tissue response and to answer any questions you might have regarding your new smile design. For example, if you grind or clench your teeth, please let us know. We can fabricate a soft night guard for you to wear to minimize the stresses placed upon your teeth while you sleep.

The maintenance of your porcelain is relatively simple. Brush and floss as you normally would to prevent oral hygiene problems. Once placed, veneers are typically the kindest restoration to the gum tissues that we currently have available. Don't be afraid that you'll damage your veneers by either flossing or brushing. Any non-abrasive toothpaste is acceptable. A good home care regimen will help ensure the aesthetic success of your veneers.

Yes, there is a real blend of art and science behind high-end aesthetic dentistry. All veneers are not created equal. Our cosmetic dentist has extensive training in the art of smile design, which determines the colors, line angles, shapes, thickness, translucency, occlusion and many other factors that our cosmetic dentist prescribes to our laboratory.

Our lab then hand makes the veneers to our specifications. Veneers should be custom-designed to fit your face, smile, gender and personality. Done correctly, they look and feel like real teeth.

You can be as much a part of the selection process as you wish, but part of why you select a cosmetic dentist is his or her experience and artistry in what looks great. Computer imaging as well as before and after photos of other cases will help you decide on the style, shape and color that work best for you. Veneers are bonded in place with a high intensity curing light.

You can tell the quality by the photos of the work you see in our office. Our Doctor creates a unique smile for each patient based on facial features preferences and must accommodate their bite exactly.

This depends entirely on the desired result. If there is only one tooth that is discolored or malformed, then a single veneer may be able to be used. To get a more balanced and even looking result, many times it is recommended that several veneers (from 4 to 9) be done at the same time. This allows us to get the most beautiful result possible. When closing large gaps between teeth, 6 to 10 veneers may be necessary to get a proper aesthetic result.

Our patients can usually get the smile of their dreams in a couple of visits. At the first veneer appointment, your teeth are prepared, impressions are taken, and you will walk out of the office with custom temporary veneers. In the second appointment, we permanently seat the veneers. Imagine getting a new smile within one month, a smile that actually fits your face and personality and gives you the confidence to express the real you!

There are no hard and fast rules about how long porcelain veneers will last. While you can certainly expect your veneers to last many years (some patients have had them for 20 or more years), it is unrealistic to expect them to last forever. With good home care and by exercising good judgment, it seems likely that a porcelain veneer could last well in excess of 10 – 15 years. Ask about our limited warranty.

There are several reasons why you may not be a candidate for veneers:

• Unhealthy Teeth - Porcelain veneers cannot be placed on teeth where there is decay or active periodontal disease (gum disease). These conditions must be treated by the dentist before porcelain veneers can be successfully fabricated and placed.
• Weakened Teeth - If a significant amount of tooth structure has been lost as a result of decay or fracture. Or else already replaced by a dental filling, the tooth may not be a good candidate for a porcelain veneer. Porcelain veneers do not significantly strengthen the teeth on which they are placed. Teeth that have, or have had, a history of a loss of a significant amount of tooth structure are usually better treated by placing a dental crown on them, not a porcelain veneer.
• Inadequate Tooth Structure - Some teeth, as a result of excessive wear or previous attempts at dental work, may have inadequate tooth structure. These teeth do not make good candidates for porcelain veneers.
• Bruxism - Persons who clench and grind their teeth can make poor candidates for porcelain veneers. The forces created by these activities, called bruxism by dentists, can easily chip or break porcelain veneers. Possibly a person can successfully control their bruxing habits during their waking hours, but during sleep a bruxer has essentially no control over this activity. If a person who bruxes does have veneers placed, the must be committed to wearing an acrylic dental night guard when they sleep so to minimize the amount of stress placed on their veneers.

If your porcelain veneer comes off, carefully remove the veneer from your mouth without damaging it further. If you have found only one piece then the veneer may not have broken but instead may have just become dislodged from your tooth, fully intact. If the veneer is whole, the dentist may be able to re-bond it to your tooth so place it in a protective container. Even if the veneer is broken it's not a bad idea to save the parts and show them to the dentist. They could possibly be of interest. Then, give us a call to schedule a repair.

Ask the dentist for specific instructions but, in general, if a porcelain veneer where only a minimal amount of tooth structure has been removed to make the veneer has simply broken or come off, there is little potential for a serious tooth problem developing. Remember, in many cases teeth in the process of being veneered are left uncovered for the entire one to two weeks during which their veneers are being fabricated. Since all or part of the veneer is missing, you can expect that your tooth's shape might be rough or irritating to your lip or tongue. The tooth itself could be expected to have a heightened sensitivity to hot or cold foods and beverages, because the veneer is no longer there to cover and protect the tooth's front surface.

Since teeth whitening has now become the number one aesthetic concern of many patients, there are many products and methods available to achieve a brighter smile.

Professional teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel, and is an ideal way to enhance the beauty of your smile.  Over-the-counter products are also available, but they are much less effective than professional treatments and may not be approved by the American Dental Association (ADA).

As we age, the outer layer of tooth enamel wears away, eventually revealing a darker or yellow shade.  The color of our teeth also comes from the inside of the tooth, which may become darker over time.  Smoking, drinking coffee, tea, and wine may also contribute to tooth discoloration, making our teeth yellow and dull.  Sometimes, teeth can become discolored from taking certain medications as a child, such as tetracycline.  Excessive fluoridation (fluorosis) during tooth development can also cause teeth to become discolored.

It's important to have your teeth evaluated by your dentist to determine if you're a good candidate for bleaching.  Occasionally, tetracycline and fluorosis stains are difficult to bleach and your dentist may offer other options, such as veneers or crowns to cover up such stains.  Since teeth whitening only works on natural tooth enamel, it is also important to evaluate replacement of any old fillings, crowns, etc. before bleaching begins.  Once the bleaching is done, your dentist can match the new restorations to the shade of the newly whitened teeth.

Since teeth whitening is not permanent, a touch-up may be needed every several years to keep your smile looking bright.

The most widely used professional teeth whitening methods

Home teeth whitening systems - At-home products usually come in a gel form that is placed in a custom-fitted mouthguard (tray), created from a mold of your teeth.  The trays are worn either twice a day for approximately 30 minutes, or overnight while you sleep.  It usually takes several weeks to achieve the desired results depending on the degree of staining and the desired level of whitening. Click here for detailed information and video.

In office teeth whitening - This treatment is done in the dental office and you will see results immediately.  It may require more than one visit, with each visit lasting 30 to 60 minutes.  While your gums are protected, a bleaching solution is applied to the teeth.  A special light may be used to enhance the action of the agent while the teeth are whitened. Some patients may experience tooth sensitivity after having their teeth whitened.  This sensation is temporary and subsides shortly after you complete the bleaching process, usually within a few days to one weak. Click here for detailed information and video.

Porcelain Veneers - This is a quick and permanent way to whitening teeth to the shade determined by you and the doctor. Click here for detailed information and video.

Teeth whitening can be very effective and can give you a brighter, whiter, more confident smile!