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Your first visit at our office is very important in establishing your oral health baseline. We will perform a complete oral examination which includes an oral cancer screening, periodontal evaluation, an analysis of your occlusion (bite) and a thorough examination of your teeth, their supporting structures and of the oral anatomy.
Invisalign straightens your teeth without wires and brackets, using a series of clear, customized, removable appliances called aligners. It's virtually undetectable, which means hardly anyone will know that you're straightening your teeth.
The Invisalign System combines advanced 3-D computer graphics technology with 100-year-old science of orthodontics. Invisalign aligners are designed to move your teeth in small steps to the desired final position prescribed by your orthodontist. Each aligner is precisely calibrated and manufactured to fit your mouth at each stage of the treatment plan. Your first step is to visit our office to determine if Invisalign is right for you. After sending precise treatment instructions, Invisalign uses advanced computer technology to translate these instructions in a sequence of finely calibrated aligners -- as few as 12 or as many as 48. Each aligner is worn for about two weeks and only taken out to eat, brush and floss. As you replace each aligner with the next, your teeth will begin to move gradually -- week-by-week until the final alignment prescribed is attained. Then you'll be smiling like you never have before!
Traditional dental restoratives, or fillings, include gold, amalgam, porcelain, and composite. With the advent of the newest technologies in dental science, today's state-of-the-art restorative materials include ceramic and the latest composite materials. These materials are not only strong and durable, but restore the look of natural teeth and are very aesthetically pleasing.
The terms dental crowns and caps are synonymous. Crowns are typically used to restore a tooth's function and appearance following a restorative procedure such as a root canal. When decay in a tooth has become so advanced that large portions of the tooth must be removed, crowns are often used to restore the tooth. Crowns are also used to attach bridges, cover implants, or to prevent a cracked tooth from becoming worse. Crowns also serve an aesthetic use, and are applied when a discolored or stained tooth needs to be restored to its natural appearance. Crowns are fabricated in a laboratory and are made either of porcelain baked onto a metal substrate, all-porcelain, or many of the new ceramic materials that have been developed.
With proper care, most teeth that have had endodontic (root canal) treatment can last as long as other natural teeth. However, in some cases, a tooth that has received endodontic treatment fails to heal as expected due to re-infection or other complications. A retreatment is similar to an initial root canal but instead of removing the pulp tissue
We take pride in creating and maintaining beautiful and healthy smiles for our younger patients in an environment that is lighthearted and fun. We focus on establishing oral health habits that last a lifetime, with education and prevention as our primary tools.
Diagnosing and treating periodontal disease, oral pathology, cosmetic periodontal procedures and dental implant. Periodontal disease and decay are caused by bacterial plaque, which is the primary cause of gum disease in susceptible individuals. Plaque is a colorless film that sticks to your teeth at the gumline. Plaque constantly forms on your teeth, and if it is not removed, it will harden into a rough, porous substance known as calculus (or tartar).
Millions of Americans Suffer from chronic facial and neck pain as well as severe, recurring headaches. In Some cases, this pain is due to temporomandibular disorder, also known as TMD.
Your temporomandibular joints, or TMJs, connect your lower jawbone to your skull. These joints get a lot of use throughout the day as you speak, chew, swallow and yawn, Pain in and around these joins can be unpleasant and may even restrict movement.
Symptoms of TMD include:
If you feel that you might have TMD, it is always important to see your dentist and receive an exam. However, not all jaw pain is associated with TMD, and if you do not have TMD, there are many different preventive steps you can take to maintain a healthy, strong smile.
According to the National Institute of Dental and Craniofacial Research (NIDCR), 3.75% of adults 20 to 64 in the United States are completely edentulous. For the overall population in this age group, the average number of remaining teeth is 24.92 out of a total of 32 permanent teeth.
One of the ways to replace missing teeth to restore oral function and appearance is with dentures. Depending upon the needs of a case, dentures can be used to replace either a few teeth that have been lost or all of the teeth in the upper or lower jaws. In addition to reestablishing the look of a complete and natural smile, dentures also restore support to the natural contours of the face to eliminate the “sunken” appearance that results from losing multiple teeth. Whether teeth have been lost for reasons of tooth decay, gum disease, a medical condition, congenital anomaly, or trauma, dentures are an effective method of care.
Dentures are removable appliances that are designed to precisely and comfortably rest on top of the gums that cover the jawbones. They can be taken out of the mouth for brief periods of time to fulfill the oral hygiene requirements of maintaining the underlying tissues, cleaning the dentures, and sleeping.
Types of Dentures
The two main types of dentures are: full dentures and partial dentures. Both types are custom fabricated based on the exact specifications obtained from dental impressions and detailed functional as well as esthetic information provided by the dentist.
Full Dentures
Full dentures, which can also be referred to as, “complete Dentures,” are designed to replace all of the upper or lower teeth. A complete maxillary denture, more commonly known as a, full upper denture, typically consists of a base that covers the roof of the mouth with a full complement of artificial teeth set around the section covering the dental arch. On the other hand, a complete mandibular denture, or full lower denture, is designed to accommodate the tongue and is horseshoe shaped with teeth set along the portion that covers the underlying dental arch.
Partial Dentures
A partial denture is a type of removable prosthesis that is designed to restore a complete and functional smile in cases where multiple teeth are missing or require extractions, while some healthy teeth remain in the dental arch. Custom fabricated for a precise fit and cosmetically pleasing appearance, partial dentures are typically secured and stabilized with clasps or precision attachments to select teeth adjacent to the edentulous areas. Depending upon the number of teeth being replaced as well as the functional and aesthetic requirements of the case, a partial denture can be fabricated from a combination of cast metal and acrylic materials, acrylic alone, or thermoplastic resins such as ValplastTM, Flexite®, Duroflex® and tcs®.
Fixed dental bridges involve the preparation and crowning of teeth on either side of an area missing teeth to support artificial teeth to span the edentulous area.
A fixed bridge is a non-removable appliance fabricated to replace missing teeth, which closely resembles a patient’s natural dentition. Besides serving to restore the appearance and performance of a complete smile, a fixed bridge also prevents teeth that are adjacent to or opposite the edentulous area from shifting to protect the integrity of the occlusion. Fixed bridges are strong, durable and natural looking restorations, which once they are permanently cemented into place allow all manner of normal oral function.
How are fixed bridges fabricated?
Fixed bridges are typically fabricated over the course of multiple visits and involve the preparation of the adjacent supporting teeth, impression taking, the placement of a temporary bridge as well as the try-in and cementation of the permanent restoration. The teeth located on either side of the edentulous area that are crowned to provide support for the bridge are referred to as the “abutment teeth,” while the artificial tooth (or teeth) spanning across the empty space are known as “pontics.”
With the dental technology available today, bridges can also be completely supported by implants without any preparation or crowning of the adjacent natural teeth required. Depending upon the aesthetic and functional needs of a case, fixed bridges can be fabricated from different dental materials including porcelain, porcelain fused to metal, or engineered ceramic-like products such as zirconia.
Dental implants represent the most recent and advanced method of replacing lost or missing teeth. Invented in 1952 by a Swedish surgeon named Per-Ingevar Branemark, dental implants today offer a highly effective, long-term solution for replacing missing teeth to reestablish a fully functional and attractive smile. Dental implants can be used to replace a single tooth, multiple teeth or all of the upper and/or lower teeth.
A dental implant is a small, biocompatible post that is surgically positioned by means of a minimally invasive procedure into the jawbone beneath the gums. Once healing takes place and the implant integrates with the bone, it behaves in much the same way as the root of a natural tooth to provide support for an aesthetically appealing dental crown or bridge. A period ranging from 3 to 6 months is required for the jawbone to fuse with the implant via a process known as osseointegration.
Dental implants offer several advantages over traditional methods of tooth replacement including:
According to clinical studies, dental implants have a demonstrated long-term success rate of well over 95%. One key to the success and longevity of a dental implant is that sufficient bone is present to provide stable support for the implanted surgical post. If insufficient bone is present, a bone grafting procedure is often recommended prior to the placement of a dental implant. Additionally, candidates for dental implants should be free of periodontal disease and be aware that a continued, effective oral hygiene routine and care is necessary to maintain a strong and functional implant.
Treatment planning a patient for the precise placement of a dental implant involves advanced scanning technology and software to map out the details of care from both a prosthetic and surgical prospective. In this way a case can be planned and meticulously executed from the beginning with the final restoration in mind. With advances in implant dentistry multiple approaches to care are now being offered. In certain cases an implant can be placed at the same time a dental extraction is performed. This procedure is known as, “immediate dental implant placement.” Additionally, it is also sometimes possible to place “same-day dental implants.” With this procedure a temporary crown or bridge can be attached to the implants at the same time they are placed. In all cases, complete healing and osseointegration is required before the placement of the final prosthesis.
Most dental implants are made of titanium but are also available “metal-free” zirconia. Both titanium and zirconia are biocompatible materials, which integrate well with the hard and soft tissues in the jaw. Depending upon the requirements of the case, a single dental implant can be restored with a crown to replace one missing tooth, or multiple implants can be used to support a fixed bridge. In cases where all of the upper and/or lower teeth are missing a full-arch, implanted supported bridge can be placed. Special implants can also be placed for added support and stability for removable overdentures or as anchorage devices in orthodontics called “TAD’s” or Transitional Anchorage Devices.
Dental bonding is a procedure that is often used to restore teeth affected by decay as well as for the repair of chipped or fractured teeth and masking a range of dental imperfections such as stains, discolorations, gaps, misshapen, or undersized teeth. A popular method for restoring and improving the appearance of a person’s smile, dental bonding qualifies as a cosmetic procedure by virtue of the fact that the composite resins used for the procedure are tooth-colored and come in a range of shades that blend seamlessly with natural tooth structure.
A dental bonding procedure, which is performed to fill a cavity or to cosmetically repair a chip, fracture, enamel defect or gap between teeth is known as a “direct composite restoration.” For a direct composite restoration, both artistry and precision are required as the dentist places the selected shade of composite resin and carefully sculpts it to rebuild or improve the appearance of a tooth.
In terms of the cosmetic repair of dental defects, the masking of discolorations or the closure of gaps between teeth, a dental bonding procedure is considered the most economical and quickest method of care out of all the cosmetic solutions available for these types of corrections. Unlike porcelain veneers or ceramic crowns, dental bonding is a minimally invasive, one-visit cosmetic procedure. Moreover, unless a cavity is being cleaned and prepared prior to a dental bonding procedure, no drilling of tooth structure and no anesthesia is required.
How is a dental bonding procedure performed?
When performing a bonding procedure, it is important to enable the composite resin to firmly adhere to the underlying tooth structure. To do this the surface of the tooth is etched and then painted with a liquid bonding agent just prior to the placement of the filling or cosmetic bonding. As the dentist places the composite resin, it is carefully sculpted to achieve the desired shape and then cured with a special light or allowed to set. Once hardened, the newly bonded restoration is polished and buffed for a smooth finish. Some dentists may offer composite veneers as an alternative to porcelain veneers, artistically bonding and blending successive layers of composite resin to transform the appearance of a tooth.
Caring For Bonded Teeth
While a bonding procedure offers an excellent and cost-effective method of care for the treatment of minor cosmetic dental issues, there are a couple of considerations with this approach. Teeth that are restored or cosmetically enhanced with a dental bonding procedure are as a rule more susceptible to staining and chipping than with other types of cosmetic treatments. For this reason, highly pigmented foods and drinks are to be avoided along with tobacco products. As dental bonding can easily chip and break, it is also important not to bite into hard objects or foods and to avoid oral habits such as biting one’s nails or chewing on pens. However, with proper hygiene and care, a bonded restoration can last for many years.
A teeth whitening procedure or bleaching simply refers to any process that will make the teeth appear whiter. It is considered a non-invasive procedure that is designed to whiten and brighten teeth that are stained, discolored, darkened, or yellowed. First introduced to the public in the 1980’s, the popularity of teeth whitening products and procedures has soared. According to a survey conducted by the American Academy of Cosmetic Dentistry, when respondents were asked, “What would you like to improve most about your smile?” The most common response was: whiter and brighter teeth.
How white a tooth appears depends upon how light is reflected and scattered off the enamel, the outermost layer of the tooth. Teeth can look dark or discolored for a variety of reasons, with an imperfect appearance the result of outer surface stains or discoloration from within the tooth. While external tooth stains are typically due to certain foods and tobacco, internal tooth discoloration is mainly the result of hereditary factors, certain medications, tooth decay, restorations, or trauma. Additionally, the aging process can influence the color of a tooth. This is because over time the outer layer of enamel becomes thinner showing more yellowish tones from the underlying layer of dentin.
What are the advantages of a professional teeth whitening procedure performed by a dentist?
Although over the counter teeth whitening systems purchased in stores or online have become popular, there are health concerns and limitations with these products. If the manufacturers protocol is not correctly followed, certain products can damage the teeth and soft tissues in the mouth, and may not deliver the results as promised. Teeth whitening systems contain varying concentration of either hydrogen peroxide or carbamide peroxide, which act as the bleaching agents. When sensitive teeth, exposed roots, cavities, broken fillings, cracked teeth, or loose dental work are present, a teeth whitening procedure may be contraindicated. Also, since whitening systems do not have an effect on the color of dental fillings, crowns or bridges the presence of restorations is an important cosmetic consideration in treatment planning.
In general, individuals with yellow tones to their teeth respond best to teeth whitening procedures. Brown and grayish tinted teeth bleach respond less well and may require significantly longer dentist supervised tooth whitening regimens or alternative cosmetic treatments. Finally, teeth whitening may not be recommended in the presence of sensitive teeth, worn enamel and significant gum disease.
As a rule the healthiest and most effective methods of teeth whitening are the ones managed and supervised by the dentist. An in-office teeth whitening procedure as performed by the dentist is the most reliable and safest way to get the maximum results quickly. In as little as one hour a prescription-strength, in-office whitening procedure can dramatically whiten and brighten the natural teeth by several shades, while the surrounding tissues and any sensitive areas of the teeth are carefully isolated and protected from the bleaching agents.
A home whitening system from the dentist along with custom trays that have been fitted to the teeth is also an excellent option. Custom trays keep the bleaching agent in maximum contact with the teeth and away from the other areas of the mouth. With a take-home teeth whitening system, maximum results are less rapid than an in office procedure and are typically achieved over a longer period of time. A home whitening system can be used by itself or as recommended by the dentist as a follow up to an in office procedure in order to perfect or maintain the results.
For teeth with imperfections that cannot be addressed with teeth whitening procedures, but are not so flawed as to require full coverage crowns, dental veneers can provide the desired cosmetic improvements.
Dental veneers are custom-fabricated facings that offer a conservative and cosmetically pleasing way to improve the appearance of teeth that are chipped, gapped, worn, slightly crooked, misshapen or darkly stained. With dental veneers, the color, shape, size, and length of the teeth can be changed for the better. Bonded to the front surfaces of the teeth, veneers can be used to enhance the appearance of a single tooth or multiple anterior teeth.
The two most common types of veneers are porcelain veneers, which are also known as porcelain laminates, and composite veneers. While porcelain veneers are the most commonly offered option in care, composite veneers can also achieve excellent results. Starting with a smile makeover consultation and a comprehensive assessment of a patient’s oral health as well as a discussion of the cosmetic goals, the dentist will determine a treatment plan to achieve the most pleasing outcome of care.
Porcelain Veneers
Porcelain veneers are ultra-thin facings that are custom fabricated from the highest grade of dental ceramics and offer the following benefits:
Composite Veneers
When direct composite veneers are the selected method of care, the dentist applies carefully selected shades of tooth-colored composite resins to the fronts of the involved teeth. As the composite resin is placed, it is meticulously sculpted to create the desired shape, length and overall form of each tooth. Each layer of applied composite is then cured with a special light, and additional layers of composite are placed as required to achieve an aesthetically pleasing and functional result. Once the final result is completely set, the dentist will smooth and polish the direct composite veneers to a naturally brilliant finish.
While composite veneers frequently offer the advantages of being a single visit procedure, easy to repair and an economical alternative to porcelain veneers, they are not as strong or resistant to staining and wear as dental ceramics. However, by avoiding certain dietary choices and habits, practicing good oral hygiene and getting routine dental care, direct composite veneers can offer an effective and long lasting cosmetic smile improvement.
Once commonly referred to as, “porcelain jackets,” today’s all-ceramic crowns are fabricated from advanced generations of aesthetically appealing, lifelike materials affording strength and durability approaching that of tradition metal and porcelain fused to metal crowns (PFM).
When a tooth requires a full coverage restoration to rebuild its structural integrity and appearance, how good the crown will look and how well it will withstand the forces of oral function are major considerations in choosing the type of crown. In the past, only metal crowns or ones fabricated out of porcelain fused to an underlying substructure of metal offered the strength required to bite and chew without breaking. While porcelain fused to metal crowns to this day remain a popular choice for strong, attractive and long-lasting restorations to rebuild teeth that are damaged, decayed, misshapen, worn down, undersized, or have had a root canal procedure, there are some drawbacks. For one thing, the thin metal margin at the collar of a PFM crown may be visible at the gumline (especially in the presence of receding gums). Also, due to the presence of an underlying metal shell, porcelain fused to metal crowns do not come close to handling light in the same way as natural tooth structure or dental ceramics.
Advantages of Ceramic Crowns
While the trade off between appearance and strength used to mean that porcelain or all-ceramic crowns looked better but did not have the strength and durability of porcelain fused to metal crowns that is no longer the case. All-ceramic crowns are not only capable of producing incredibly lifelike results, but thanks to the range of materials available today, all-ceramic crowns are stronger and more reliable than ever before.
Some of the advantages of all-ceramic crowns include:
With the range of engineered dental ceramics available today, which material is selected for crown fabrication depends upon the location of the tooth, the stresses on that tooth and the esthetic requirements of the case. Certain all-ceramic crowns are more suited for back teeth, while others are able to fulfill the aesthetic requirements presented by a front tooth. Some of the all-ceramic crowns used today include Feldspathic porcelain crowns, Empress crowns, Procera crowns, Lava crowns, Zirconia crowns, and Emax crowns.
A healthy, functional and attractive smile requires teeth that are straight and jaws that are well aligned. A good bite with teeth that are straight not only looks good, it contributes to overall oral health and well being.
Braces are orthodontic devices that are used to address problems such as crooked, gapped or crowded teeth, overbites or underbites and improper jaw relationships. With advances in orthodontic technology and systems of care, a wide selection of braces is available today. Providing effective and efficient care, these choices are far less bulky, much less noticeable, and more comfortable than previous generations of braces.
The type of braces the dentist recommends for a patient’s case depends on several factors including:
The most common type of braces worn today, remain “metal braces”. Made of high-grade stainless steel these braces are significantly smaller and have a lower profile than their predecessors from years ago. Each brace, which is known as an orthodontic bracket, is individually bonded to the front of each tooth. Metal braces allow for efficient and highly controllable tooth movement.
When conventional braces offer the best approach to care, but a more cosmetic appearance is desired, ceramic braces provide an excellent alternative to traditional metal brackets. Ceramic braces, or clear braces, blend in with the natural color of your teeth, making it less obvious to others that you are wearing orthodontic appliances. While being far less visible, they still function in very much the same way as metal braces.
Today, there are even metal braces that can be placed on the “tongue side” or lingual of every tooth, so that they are in effect completely hidden from the outside world. These braces work in the same way as the metal or ceramic braces affixed to the front of the teeth, but can be more uncomfortable and more difficult to keep clean due to where they are located.
One of the most recent options in orthodontic treatment that has provided a more discreet, convenient and comfortable method of care is a custom sequence of removable clear aligners that gradually move the teeth into their correct positions.
Invisalign® is a form of orthodontic treatment that works to correct many different types of malocclusions through the use of a series of clear plastic trays called aligners. As a more discreet, comfortable and completely removable method of care, Invisalign aligners provide an effective alternative to traditional orthodontic braces and metal wires for certain types of malocclusions.
Developed by a team of Stanford University students, the advanced 3D imaging, modeling, and aligner technology that defines the Invisalign system of care was introduced to the public in the year 2000. Since that time, it has become an extremely popular option in care.
Invisalign uses advanced 3-D computer imaging technology to formulate a sequence of custom-made clear aligners. The aligners, each of which is worn for a couple of weeks, incrementally move the teeth into place until the final desired corrections are reached. The advantage and appeal of the Invisalign method are that the clear aligners are more cosmetic, comfortable and convenient than other orthodontic appliances and operate with minimal interference to daily activities. Invisalign allows teens and adults to enjoy eating all of their favorite foods, and engage in sports without the fear of breaking their orthodontic appliances or sharp poking wires. Moreover, as the aligners are completely removable, tooth brushing and flossing are much easier as there is no need to clean in between any attached orthodontic brackets or wires.
*Invisalign is a registered trademark of Align Technology, Inc.
A toothache is the most common reason for oral pain. It is an uncomfortable, distressing and debilitating situation that if left untreated can result in serious consequences to an individual’s oral health as well as overall well-being. Depending upon the underlying cause of a toothache and the degree of damage to the tooth and involvement of the surrounding tissues, the type and severity of symptoms can vary. While mild symptoms of discomfort are easy to dismiss and ignore, waiting until toothache pain is more consistent or severe is not advised. The best option is to make a timely appointment with the dentist for a professional assessment and care.
Although the reason for most toothaches is cavities (tooth decay/dental caries), a toothache or what may feel like pain related to the teeth can be due to any number of underlying conditions including:
Different types and degrees of toothache pain can point to different underlying causes and help in the diagnosis of the problem. Sharp and stabbing pain when eating or drinking hot and cold foods may be due to the presence of a cavity or exposed dentin and sensitive teeth. Pain with pressure or biting down may indicate a cavity or even a broken filling, a cracked tooth or periodontal problem. If the pain is continuous or throbbing, it is a sign that tooth decay or trauma has affected the nerve of a tooth or that an infection requiring prompt care is present. Localized swelling around the tooth or more generalized tissue and facial swelling and fever must be taken care of as quickly as possible.
Treatment of a toothache depends upon the diagnosis of the underlying problem, the degree of damage to the involved tooth or surrounding tissues and if any infection is present. Once the dentist has performed a comprehensive evaluation of the case, the appropriate recommendations and care to alleviate the symptoms and restore oral health will be provided.
Traumatic oral injuries can range from dental injuries to the teeth and their supporting tissues to lacerations in and around the mouth as well as more complex and severe damage to the soft tissues and bones of the face. These injuries are often caused by direct physical trauma to the teeth, mouth and face that may be the result of a fall, sports or work related incidents, motor vehicle accidents or assaults.
Chipped, Fractured or Cracked Teeth
It is not uncommon for a tooth to sustain a chip, crack or fracture. It may happen simply from biting down on a piece of ice, chewing on a pencil, or sustaining trauma such as a direct blow to the face and mouth. The damage to a tooth can range from a minor craze line or a small chip of the dental enamel to a more extensive fracture of the tooth that can even go so far as to fracture the root or split the tooth. Based upon the extent of damage to the fractured or cracked tooth, treatment may simply involve placing a suitable restoration such as a filling or crown or a root canal procedure along with a restoration. When the damage is extensive, an extraction is sometimes required.
Dentoalveolar Injury
Dentoalveolar injuries refer to traumatic injuries involving the teeth and the bone surrounding the teeth. These injuries can include teeth that have been dislodged or moved partially out of their sockets, with or without a segment of the adjacent bone, or an avulsion, which means that a tooth has been completely “knocked out” of its socket. In these situations, immediate dental care to reposition and stabilize the involved teeth and/or put the bone back into the correct anatomical positions is required. Beyond the routine post op care to check for tissue healing, the involved teeth are typically followed for a longer period of time to check for subsequent nerve involvement or other issues that may require additional care.
Soft Tissue Injuries
Soft tissue injuries in and around the oral cavity include lacerations within the mouth (intra-oral) and facial lacerations. If possible clean the area gently with water and apply a cold compress. For puncture wounds, tissue tears, and lacerations to the lips, cheeks, tongue or any other tissues in and around the oral cavity, prompt emergency care is required.
Dislocated or Fractured Jaw
Facial trauma that has resulted in a suspected dislocation or jaw fracture requires immediate care as problems with eating and breathing can ensue. Prompt care can minimize complications and accelerate healing. For a fractured jaw, treatment depends upon the extent of the injuries. While some clean breaks may only require immobilization, multiple fractures of the jawbone or displaced breaks involve more complex surgical care. If on the other hand the jaw has been dislocated as a result of a traumatic incident or opening the mouth too widely, it will need to be manipulated back into the correct position. For people who have had more than one dislocation, surgery may be needed to reduce the risk of further dislocations.
