Sedation Dentistry
Tooth Colored Fillings
Crowns
Dental Bridges
Dental Veneers
Teeth Whitening
Dental Implants
Dentures
Digital X-Rays

Services:

Sedation Dentistry:

Are you one of the 45 million Americans who are missing out on routine dental cleanings, check-ups and necessary dental work because anxiety or a busy schedule is keeping you away? Then Conscious Sedation Dentistry may be for you.

What is Conscious Sedation Dentistry?
Most of us are familiar with nitrous oxide (laughing gas). Sedation Dentistry works by taking a medication such as triazolam, a small blue pill, 30 minutes to one hour before the appointment. Various dosages may be given during the treatment appointment, depending on the severity of the anxiety and the patient's response. Oral Sedation protocols have been used safely for 30 years. One of the dentists will review your medical history and monitor you closely while under sedation.

Am I a Candidate?
You may be a candidate if you have:

- Dental phobia
- Dental anxiety
- A sensitive gag reflex
- A previous traumatic experience
- Extra sensitive teeth
- Difficulty getting numb
- Difficulty keeping your mouth open
- Hate noises, smells and tastes associated with dental care
- Hate needles and shots
- Need extensive work or multiple procedures at one time
- Are embarrassed about your teeth

Some patients fear these factors but with the sedation, their awareness and memory of the procedure is completely blocked out.

What Are the Advantages of Sedation?
The medicine Conscious Sedation has an "amnesia" quality, which for most patients tends to prevent almost any memory of the visit. The advantage is that the brain doesn't "register" the work that was done, so there is no lingering discomfort!

By being totally relaxed, you reduce joint and gum soreness. The medicine allows you to have more work done comfortably at one time. You can have your exam, general dentistry, cleaning, root canals and even some cosmetic procedures all done in one visit instead of the traditional two to four visits.

Will I be In Control?
Absolutely! Remember, it is "Conscious Sedation." You will have full control of bodily functions and reflexes. We also have the ability to bring you in and out of sedation as required. Most patients tend to nap lightly. However, you can respond to verbal commands and communicate should the need arise.

Types of Sedation
Depending on the extent of the anxiety, two different methods can be used to make your dental experience a comfortable one:

1) Oral Sedation:
medications of various dosages can be given to the patient 30 minutes to an hour before the appointment or at the time of the appointment, depending on the severity of the anxiety.

2) Nitrous Oxide:
also known as laughing gas, is used to induce a state of relaxation.

The dental sedation methods listed above can provide varying degrees of sedation. These include:

1) Anxiolysis:
light sedation. Nitrous oxide or oral medications are the most commonly used sedation methods to induce this type of relaxation.

2) Conscious Sedation:
mild sedation. Nitrous oxide or oral medication can induce this type of sedation. The patient will be awake and able to respond to commands.

3) Deep Sedation:
a state between consciousness and unconsciousness. The patient will not be able to respond to commands in a consistent manner and may need some assistance with breathing in the event they are unable to keep their airway open.

Sedation Process
At your initial consultation, where the entire process is explained, we will review your medical history and take baseline readings of your blood pressure, pulse and oxygen saturation level. We also will review pre-op and post op instructions then schedule your conscious sedation dental work.

At your appointment, you will be drowsy and unaware of the time passing by. Our specially trained team will monitor you throughout the appointment. Your vital signs (heart rate, blood pressure and oxygen) are fully monitored until your appointment is over. When you awake, you'll be done with the dentistry and feel relaxed and comfortable. And best of all, you usually won't remember the treatment appointment.

You'll experience a special understanding and sensitivity towards your needs. We do offer Nitrous Oxide as an alternative to oral Sedation Dentistry. Many patients who are treated with Conscious Sedation frequently say they don't even remember being at the dentist!

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Tooth Colored Fillings:

Most of us have had amalgam fillings (silver) or gold filling restorations. Some amalgam fillings were what we have called mercury fillings, as some amalgam fillings contained mercury. Metal fillings were effective, but very conspicuous and tended to blacken in color over time.

How are tooth colored fillings (or) composite resin fillings different from amalgam fillings?
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 Dental Fillings, are made of a plastic dental resin. Composite Resin Dental Fillings are strong, durable, and make for a very natural looking smile. Many dental insurance plans cover their use.

How are composite resin fillings accomplished?
Your dentist will give you a local anesthetic to numb the area. The dentist then prepares an access to the decayed area of the tooth and removes the decayed portions. This is accomplished with traditional drills, micro air abrasion or even with a dental laser. With a composite filling, your dentist will preserve more of the natural tooth as the composite resin can be bonded to the tooth in thin layers.

A special dental material is then used to open up the pores of your tooth's dentin and roughens up the surface of the exposed enamel. This achieves better and stronger bond. The bond resin is applied to stick the composite to your tooth. This material is made of the same dental resin as the composite however it is much more fluid. This layer is then hardened and cured with a very bright light.

Once your filling is completed, your dentist will use a special paper, articulating paper, to adjust the height of your dental filling and that your bite remains correct. Your tooth is then polished. If such a filling is not going to be enough to protect your damaged tooth, or if your tooth enamel is thin and will easily fracture, or if your tooth has had a root canal that weakened your tooth condition, your tooth may require additional protection such as a crown.

Composite Resin Fillings
There are no known health risks of receiving composite fillings. 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 Dental Fillings, are made of a plastic dental resin. Composite Resin Dental Fillings are strong, durable, and make for a very natural looking smile. Many dental insurance plans cover their use.

Inlays and Onlays
If over half of your molar tooth's biting surface is decayed an inlay or onlay may be a better option than a filling. These options are basically for when more than a filling is needed but less than a crown will do. An inlay is placed in between the cusps of the tooth, whereas an onlay will cover one or more of the cusps. They can be made of a gold alloy, porcelain or tooth-colored resin and are cemented into place.

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Crowns:

Grinding your teeth, an improper bite, age, fillings and tooth decay can all be contributing factors in the wearing down, cracking or breakage of your teeth. Dental crowns cover the entire visible surface of your affected tooth and add strength, durability and tooth stability.

How are Tooth Crowns Attached to your Tooth?
Your cosmetic dentist will make an impression of the tooth and a dental laboratory will create the crown. You will typically leave the office with a temporary crown to wear while the permanent crown is being made - this takes about two weeks. The permanent crown is then cemented onto your tooth. Typically, only two visits are required for this part of the procedure. Often, a preliminary restoration of your tooth may be needed before a crown can be placed. To stabilize your tooth, a filling must first be put in place prior to placing a crown due to the loss of original tooth structure.

In some cases your cosmetic dentist may choose to use a Flipper instead of a temporary crown. A Flipper is a false tooth to temporarily take the place of a missing tooth before the permanent crown is placed. A Flipper can be attached via either a wire or a plastic piece that fits in the roof of your mouth. Flippers are meant to be a temporary solution while awaiting the permanent crown.

There are basically three types of crowns, those made of gold, ceramic crowns and ceramic-veneered gold crowns. Gold and metal-ceramic crowns are extremely durable and are normally used in molars, where the forces from chewing and grinding are most prevalent. All ceramic crowns are used for front and back teeth.  They best resemble the natural tooth color.

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Dental Bridges:

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. The 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.

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. 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 will last as many ten years or more.

Overview of dental bridge procedure
If you have a space from a missing tooth, a bridge will be custom made to fill in the space with a false tooth. The false tooth is attached by the bridge to the two other teeth around the space - bridging them together.

How is dental bridge accomplished?
Your cosmetic dentist will 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 the cosmetic dentist will remove the an area of each abutment (teeth on either side of the space) to accommodate for the thickness of the crown.

The dentist will then make an impression, which will serve as the model from which the bridge, false tooth and crowns will be made by a 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.

Your cosmetic dentist may have you use a Flipper appliance. A Flipper is a false tooth to temporarily take the place of a missing tooth before the permanent bridge is placed. A Flipper can be attached via either a wire or a plastic piece that fits in the roof of your mouth. Flippers are meant to be a temporary solution while awaiting the permanent bridge.

On your second appointment, the temporary bridge will be removed. Your new permanent bridge will be fitted and checked and adjusted for any bite discrepancies. Your new bridge will then be cemented to your teeth.

There are three types of dental bridges:

1) 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 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.

2) Resin Bonded Bridges
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 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.

3) Cantilever Bridges
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 the false tooth to one side over one or more natural and adjacent teeth.

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Teeth Whitening:

Teeth whitening is used to correct discoloration of the teeth by removing the brown and yellow staining.  Before the patient embarks on the home teeth whitening regimen, the dentist creates a custom mouth tray for the patient. The custom tray is a critical component of the treatment. It ensures that the correct amount of whitening solution is used and that the patient's teeth are properly exposed to the whitening solution. The custom made mouth tray provides for a better fit than a one-size-fits-all mouth tray to help increase the margin of patient safety.

The steps in the home teeth whitening regimen are fairly straightforward. The dentist's office provides the patient with the materials and instructions and also answers questions the patient may have about the routine. Your dentist's office can also provide you with off-site supervision should you have any questions once you've begun.

A home whitening session can last for one to three hours, during which time you will have the tray and solution in your mouth.   Depending upon your needs and desired results, your dentist may instruct you to keep the tray in your mouth overnight.  Typically, you will follow your home teeth whitening regimen for seven to ten days.

Teeth whitening is not a permanent procedure. Results can last for one or more years, depending upon your personal habits. In most cases, the whitening procedure is very effective and the patient is pleased with the results.

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Dental Implants:

Dental implants are a safe, medically proven, esthetic alternative to traditional crowns, bridgework, and dentures. Because implant restoration looks and feels more like natural teeth, they offer new levels of comfort, security and confidence over traditional treatments.  For more than two decades, dental implants have been helping to provide quality of life to patients with restorative needs.

How do they work?
A dental implant is a small “anchor” made of titanium that is inserted into the jawbone to take the place of your missing tooth root.  After osseointegration (when the surrounding bone has healed to the implant), a replacement tooth is secured to the tip of the implant.  This new tooth looks, feels and performs similar to your natural teeth

What are the benefits?
Choosing dental implants as a treatment option can offer you a number of significant advantages.

1) Maintain anatomy.
If you have missing teeth, the bone begins to shrink over time.  Unhealthy bone loss can make your jaw line recede and change your facial structure.  Dental implants can help prevent deterioration of the jawbone so your face retains its natural shape.  

2) Keep you healthy teeth.
 A better long-term alternative to bridgework, dental implants eliminate the need to grind down healthy teeth when replacing one or more adjacent teeth.  Your own natural healthy teeth are not compromised. 

3) Security. 
Securely anchored dental implants do not slip or move.  This eliminates some of the key problems of dentures, including poor fit, gum irritation and pain from exposed nerves.  The result is superior comfort, reliability, and freedom from embarrassment.

Why have dental implants become so popular?
As our life span increases, the need for some type of permanent dental replacement system becomes very important to our overall health. Dentures and removable bridges have obvious problems: They are loose and unstable. Implants can provide people with dental replacements that are both functional and esthetic. The demand was always there, we just needed the tools to fulfill that demand.

How long after a dental implant is placed can it be used to anchor my new teeth?
The protocol that was originally developed clearly states that we must wait six months in the lower jaw and twelve months in the upper jaw before we can begin to construct the new dental prosthesis that will be supported by the implants. In recent years, however, there has been a movement within the profession to sort of speed up this process. Today we believe that it is possible in selected patients to accelerate the healing time. We are even loading implants in very specific situations right away. However, the general protocol that I favor is 4 months in the lower jaw and 4 months in the upper jaw.

Does it hurt to have dental implants placed?
The actual procedure to surgically place a dental implant is done under local anesthesia and is generally not at all painful. When the anesthesia wears off about three or four hours later, you might expect some discomfort. The level of discomfort is quite different from patient to patient, but most patients do not have significant problems. Some patients do have varying degrees of pain or discomfort which may last for several days. Swelling along with black and blueing may also develop.

In cases where there is prolonged pain, you should see your dentist right away. Prolonged pain is not a good sign with dental implants and although it does not always mean failure, the cause of the pain should be determined as soon as possible. If an implant is not properly integrating into the adjacent bone or if an infection develops, the implant may have to be removed.

A Bridge or a Dental Implant?
Perhaps one of the most frequently asked questions is whether or not to use a fixed ("permanent") bridge or a dental implant to replace one or two missing teeth. Suppose you are missing your lower left first molar. If a fixed bridge were to be used, your dentist would cut down the adjacent teeth (the second molar and the second bicuspid) and fit a three unit fixed bridge over those two teeth. The missing tooth would be called a pontic and it would be effectively replaced by the three unit bridge. If your dentist were to use an implant with a crown on it, he would place an implant in the site of the original first molar. He could do this immediately or at some date after the first molar was removed. There is no time limit here. The implant will take about 3 months to connect with the bone and then at that time, your dentist can construct a single crown on the implant to replace the missing first molar.

The cost of each one of these procedures varies from office to office, but a three unit fixed bridge costs about the same as an implant and a crown. The actual decision to do one over the other rests with you and your dentist. One technique is not inherently better than the other and each depends upon how you present and your dentist’s skills. All things being equal, I would usually prefer to place the implant and crown over the bridge.

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Dentures:

Dentures are removable replacements for missing teeth typically made out of an acrylic resin which at times incorporate porcelain or metal for additional structural support. There are two main types of dentures. Both Complete Dentures and Partial Dentures are finely crafted, custom-fitted. If you properly maintain your dentures they will appear natural and provide an adequate replacement.  Additionally, dentures help strengthen muscles controlling your expressions that require the support of your teeth, rid you of pronunciation problems caused by missing teeth and aid with chewing.

How are dentures accomplished?
It is somewhat common to require for some teeth to be extracted, and surgery in some cases is necessary to improve the bony ridges that stabilize your dentures.

The procedure begins with a wax bite impression of your mouth that will give your dentist exacting measurements. A try-in appointment will fine tune color, shape, and custom-fit. After your final dentures are fabricated, they will be fit and you will be informed of their required care.

Types of Dentures:

1) Complete Dentures
These replace all of your teeth, upper or lower. Their comfort and function depends on muscle, bones, tongue, saliva, and most importantly the patients ability to adapt to a removable prosthetic device.  

2) Immediate Dentures
Immediate Dentures are placed all at once, and may require additional adjustments after the healing process. It can take months for your bone and tissue to stabilize after tooth extractions.

3) Over Dentures
Over Dentures are a type of conventional denture similar to Complete Dentures. The difference is that not all teeth are extracted and they use one or more natural teeth for their support. This type provides greater stabilization during chewing. Over Dentures cost more and typically require more preparation dental appointments until the procedure is fully complete.

4) Partial Dentures
Designed to correct the gaps in your smile when only some of your teeth are missing. Metal attachments anchor the dentures to your natural teeth. Partial Dentures maintain tooth alignment by preventing your remaining teeth from shifting. Partial Dentures can also help prevent your loss of more teeth due to decay or gum disease.

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Digitial X-Rays

Dental x-rays can now be taken using sensors that transmit the image directly into a computer monitor. This larger image helps the patient understand the doctor's explanations more easily and enables the doctor to "zoom in" on a specific area of the tooth. An important advantage to this new technology is that it reduces the amount of radiation by up to 90%. Digital x-rays are also faster. The digital image only takes 20 seconds to appear in the monitor. In addition, this new technology is friendly to the environment since no chemicals are needed for developing the image.

What are Dental X-rays?
What most people call X-rays are actually X-ray photographs (also known as radiographs). An image is made using X-rays, which are similar to sunlight, but of a shorter wavelength, and show us what's below the surface of a tooth. Even though we call them X-rays, we are actually referring to the image created by X-rays.

Why are Dental X-rays Necessary?
X-rays are the only way to identify problems that aren't externally visible. X-rays are very essential in doing a complete and thorough dental examination. They are especially important in diagnosing serious conditions early to allow for effective treatment before you experience discomfort. X-rays show bone anatomy and density, decay between the teeth, abscesses, impacted teeth, and children’s developing permanent teeth.

How Often Do I Need Dental X-rays?
The number and type of X-rays you will need depends on several factors such as age, current dental health, and external signs that may trigger a cause for concern. We are sensitive, however, to your concerns about exposure to radiation, and we only perform those X-ray procedures that are necessary for your continued dental health.

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