Services & Treatments

Teeth Whitening

Believe it or not, over 1 billion dollars a year is spent on over-the-counter dental improvement products.  Unfortunately, most of these products do not work. Even on the most modest stains.

There is only one safe and effective solution that predictably removes stain (discoloration) from your teeth - hydrogen peroxide.  While many OTC products have hydrogen peroxide, the concentration is too weak to remove a noticeable amount of stain.  The peroxide works by oxidizing tiny particles that become stuck in the outer surface of your enamel.  These particles come from many sources and become visible over many years of being washed over the surface of your teeth.  Some common sources are dark drinks such as soda, tea, coffee, juices and wine.  A couple of ways to slow down the staining of your teeth from such sources is to brush your teeth regularly and rinse your mouth with water immediately after consumption.

There are several types of stains, but they can be divided into 2 categories: intrinsic (from the inside of the tooth) and extrinsic (on the surface of the tooth).

• Intrinsic stains can be caused from medicines, chemotherapy, minerals, heavy antibiotic use or other chemicals that can pass through the blood.  Some commonly known reasons for stains is the use of tetracycline antibiotic at an early age (0-8 years old) and excessive fluoride ingestion at an early age.  Age-related darkening of teeth can be categorized as intrinsic staining as well.  Tetracycline stains develop on teeth when portions of this drug's molecules are incorporated into the structure of the growing tooth.  The result is grey or brown teeth that do not respond to whitening. These teeth are usually very healthy and strong. Fluorosis in adult teeth is caused by by excessive amounts of the fluoride ion - again, incorporated into the structure of the developing teeth.  People who live in areas of the country where there are high fluoride levels in the drinking water can often have this condition (West Texas and the Panhandle).  Also, overuse of fluoride supplements may cause flourosis - ask your dentist if supplements are necessary for young patients.  Using fluoride to build teeth is a great idea- the tooth is stronger and more cavity resistant.  However, too much of a good thing applies here! Teeth become ‘mottled’ in appearance, patchy white and brown.  It has been observed that extreme quanities fluoride can make teeth brittle.  Whitening has a varied success rate on these teeth depending on the severity of the discoloration.
• Extrinsic stains can usually be removed to some degree with peroxide whitening.  The amount of time needed and the shade achieved cannot be predicted.  It must be noted that teeth have a maximum whiteness and that value is different for each person.  If you want teeth whiter than they can be ‘bleached’ then you must have them covered with a white porcelain or "veneers". The same is true for those darker intrinsic stains.

How We Do It ...

In our offices we use the take-home-tray method.  This is the most successful form of whitening, and trays are required for maintenance and/or desensitizing therapy for any technique of whitening.

Impressions are taken of your top and bottom teeth.  Customized clear trays are made to fit over your teeth.  A high concentration gel of buffered hydrogen peroxide is placed on the inside of the trays and the trays are placed on your teeth.  The trays are worn for 2-6 hours a day for 4-14 days.  The time depends on many factors including the concentration of gel, amount of staining and teeth sensitivity.

Many people call our office and ask what the percentage is of our bleaching gel.  Although this is an educated question, much more is involved in the strength and action of the gel:  in particular, the type of gel, concentration of active ingredients, and duration of treatment.  For example, a 7.5% gel of one type of peroxide may be equal to 20% of another, but depending on how it is used, the lesser concentration may be more effective for you.

Sealants

Deep grooves on molar teeth are the sites for most cavities in children and adults. Sealants fill in these areas protecting them from decay.  They are basically shallow fillings!  The procedure is easily tolerated and, in most cases done without anesthetics (shots) or the drill.  Sealants are most useful when placed on the grooves of the teeth as soon as they are exposed to the oral cavity (all the way through the gums).  This is usually around 6 years old (6 year molars). Adults can benefit greatly from these ‘shallow fillings’ by removing very small areas of decay from the pits and fissures of the teeth and flowing a filling material into these grooves.  This is much better than waiting until the cavity becomes large and a more significant hole must be drilled to place a conventional filling.  This is one of the reasons why dentists are now using microscopes to perform dentistry.  Detecting small cavities and repairing them is obviously better than filling a big one.

Sealants can be best described as grout lines between floor tiles. Some people have tiles that are close together - no need for grout! Others have tiles far apart (large grooves on the tops and sides of the teeth, these areas need to be filled in. Modern tooth-colored filling materials are used for this procedure.

Bonding / Tooth-Colored Fillings

Bonding is the term used for tooth-colored plastic filling material that is used to fill holes in teeth, cover and reshape teeth, or to protect areas of teeth from wear.  Bonding is a common cosmetic procedure used on the front teeth.  The material used is a composite resin that is in putty form when sculpted on to the tooth.  A high intensity light is applied onto it for several seconds that cures it into a hard plastic.  It is then shaped and polished.  This procedure is not to be mistaken with Porcelain Veneers.

Porcelain Veneers

 If you desire a significant change in your smile but you do not want to invest a great deal of time in the process then porcelain veneers may be the answer.  When you see those dramatic "smile makeovers" on TV or hear "straighten teeth without braces" ads on the radio, they are most likely using bonded porcelain technology.

Veneers are used to fill in gaps, repair fractured or discolored teeth and correct minor rotational or displaced teeth.  We do this by reducing tooth structure from the fronts of the teeth.  Depending on what is needed, the amount of tooth structure removed is variable.  In some cases no tooth structure is removed; in others, more has to be removed (e.g. a protruding tooth or rotated tooth).  Usually the amount removed is between 0mm and 1.5mm.

Basically, the procedure entails replacing the front (viewable) portions of the teeth with a thin piece of porcelain.  The porcelain can be the color and shape that is desired by the patient.  The porcelain is bonded to the front of the tooth with a very strong composite resin material.  There is a difference between "bondings" and porcelain veneers.  With bondings, tooth-colored filling material (made of plastic) is used to repair chips and fill in small gaps.  The difference between porcelain vs plastic boils down to more natural looks, durability, longevity and resistance to stain with porcelain.
 

Lumineers

Ultra-thin LUMINEERS are custom designed to give you the beautiful smile you’ve always dreamed of. Unlike traditional veneers, there are no shots, no drilling of sensitive tooth structure, and no pain. They’re even reversible, so you have nothing to lose and a beautiful smile to gain. Plus—LUMINEERS are proven to last for over 20 years, so your beautiful smile will be with you for years and years.

When you transform your smile with LUMINEERS it takes only 2 easy visits to your dentist to bring out your beautiful smile. During your first visit a precision mold will be taken. You and your dentist will also choose the right shade for your new, permanently white smile. On your second visit, your custom designed LUMINEERS are checked for fit and shade.  Then, they’re painlessly attached.

That’s it – a healthy, natural, permanently white smile you’ve always wanted in only 2 visits.

Crowns & Bridges

When a tooth is in need of repair and there is little good tooth left, or if the tooth has deep cracks or has a root canal, you may need a crown.  A crown (sometimes called a Cap) is a restoration that covers the portion of the tooth above the gums.  It can be made out of metal, porcelain or a mix of the two.  A crown may be recommended to help protect the tooth from further breakdown, keep cracks from spreading, or reshape the tooth for cosmetic reasons.  In our office we use many different types of materials depending on the patient's needs and cosmetic desires.  Our most popular material is the all-porcelain crown that we design and fabricate in about one hour.  See One-Visit Porcelain Restorations for more details.

If you have a missing tooth (or a few teeth in a row), and there are good stable teeth on either side of the space, then you are a candidate for a Bridge. A ‘Bridge’ or fixed prosthodontic restoration is basically two crowns attached to each other with another full crown.  This middle crown is not hollow; it is a solid piece with a smooth underbelly that is easy to clean with floss.  It bridges the gap between the two teeth.  Bridges are currently the most natural looking restorations available today.  A bridge is cemented in like a regular crown and it does not come off.  It is not to be mistaken with ‘bridges’ that do come off - these are called partial dentures, or just "partials".

Partial Dentures

In most cases, it is worthwhile to replace a missing tooth or teeth.  Sunken cheeks, tipping teeth and poor chewing are just a few reasons to replace teeth.  Partial dentures (removable prosthesis) are different from a ‘bridge’ (fixed partial prosthesis).  A bridge is cemented  in place permanently.  Partials can be removed.  They consist of acrylic or metal and acrylic restorations that clip onto teeth adjacent to the missing teeth.  They are an economical alternative to a fixed-bridge, but they can be cumbersome and hard to adapt to.  Often, partial dentures are a temporary solution until a fixed bridge or implants can be placed.

Digital Imaging and X-Rays

If there is one thing about your first visit to our office you may brag to your friends and family, it is the pictures of your teeth displayed on our monitors.  Our intra-oral camera allows you to see your teeth up close and personal.  With the use of this technology you are able to SEE what we are talking about.  This is a visual tool that gives you the information needed to make an educated decision about your dental treatment.

Digital x-rays are faster and safer than conventional x-rays.  They use up to 80% less radiation and are able to be viewed in about 2 seconds.  The images can be enhanced many ways to improve diagnosis.  They are also environmentally friendly - no processing chemicals are used – only a computer.  

Gum Therapy

Periodontal Disease is the leading cause of tooth loss.  It is usually unknown to the patient until it is quite severe.  Symptoms include bleeding gums, a general ache that floats from tooth to tooth, loose teeth, gaps that form between teeth over time, bad taste and bad breath (quite bad).

Periodontal therapy (gum therapy) is the process of cleaning the teeth below the gumline.  Most of the time, anesthetic is needed for the patient's comfort while the sensitive root surfaces are cleaned of bacteria and toxins (scaling and root planning or deep cleaning).  If the damage is significant (bone loss), a referral to a periodontist may be needed for further evaluation and detailed treatment.  There are two new technologies available today that improve the results of the treatment as well as the comfort level during treatment.  Arestin is a time-released antibiotic powder that is placed (at the time of treatment) into the periodontal pockets.  It kills any remaining bacteria in the surrounding tissues and prevents new infections for up to 21 days.  This allows the body to heal and catch up on reforming the tooth-bone attachment.  Go to www.arestin.com for more information.

Another neat product available to us is Oraqix, a non-injectable anesthetic that is applied between the teeth and gums painlessly.  It is used just prior to scaling and root planing, eliminating the need for an injection of anesthetic. It may not be practical if you have a full mouth of treatment, but it is perfect for "that extra sensitive spot".  Go to www.oraqix.com for more information.

Gum disease is one of the main reasons that dentists recommend regular check-ups.  Most diseases of the mouth are silent (you don’t know you have it). Just like most things, catching it early can save bone, teeth, your smile, embarrassment, and money.  A full periodontal evaluation with multimedia educational programs is the best way to understand your exact oral health.  Make an appointment with us to prevent or stop periodontal disease.  Schedule a new patient exam with a periodontal screening and cleaning today!
 

Implants

Implants are quickly becoming a standard procedure in dentistry.  Implants have been around for decades.  In the past, they were not well understood by many dentists, and due to the higher expense, patients chose more economical means of dentistry that the dentist was well practiced in.  Now, dental implants are considered by many dental professionals as a first choice option that is more conservative than the “standard” choices we as dentists have made for so many years.  Fortunately, costs have come down considerably over the years to make it very competitive with conventional treatments.  For example, if you want to replace a single tooth, say your lower right first molar, the cost of an implant and a crown to replace this tooth is approximately the same as a 3-unit conventional bridge that would be required to replace the same tooth.  Implants can also greatly benefit those of you who have all of your teeth missing.  One way they can benefit you is by providing anchors in your jaw for your dentures to attach to.  Just imagine, being able to “snap-in” your dentures and not worrying if they will fall out of your mouth at the worst time.  There are also implant procedures that allow us to build back an entire arch of teeth and have them permanently fixed into your mouth.  No more dentures floating in a cup on your nightstand!

Whether you need to replace one tooth or an entire mouth full, dental implants may be your best option.

What Are Dental Implants?

The modern dental implant, regardless of the brand, is basically a titanium screw shaped device approximately 6mm to 12mm long and 2mm-4mm wide that is placed in your bone where your natural tooth root used to be.  It functions like a bionic root!  If you are replacing a single tooth, a single crown is placed on top of this implant and that is that- a tooth with a root in the bone that functions just like your natural one.  If you are using implants for holding in a denture, multiple implants would be utilized.  In this case however, instead of placing a tooth on top of the implant, a metal attachment or “snap” would be placed and it would set just above your gumline.  The underside of your denture would be equipped with a companion piece that will firmly attach to the implant so movement of the denture would be inhibited.  In some cases, a full arch of teeth made of a metal core and porcelain (like a crown or cap)  would be screwed directly into several implants.  This implant supported type of restoration is meant to NOT come out without the help of a dentists and special tools.

Implants are placed in a couple of phases.  The placement of the implants in the bone and the placement of attachments that stick out of the gum tissue is performed by our referring Oral Surgeons or Periodontists (all the work below the gumline).  The work that is to be done above the gumline is performed in our office (crowns, dentures and/or attachments).

Oraverse

Our dental practice is now pleased to accelerate your recovery from numbness after routine dental procedures.  OraVerse^™ is the first and only product of its kind to rapidly reverse the effects of local anesthetics containing a vasoconstrictor so you can feel, speak, smile, and drink normally in approximately half the time.¹ OraVerse is not recommended for use in children less than 6 years of age or weighing less than 15 kg (33 lbs). 

For more information on this innovative new product, we invite you to visit www.OraVerse.com.

Tachycardia, bradycardia, and cardiac arrhythmias may occur with the use of phentolamine or other alpha-adrenergic blocking agents. Although such effects are uncommon with OraVerse (phentolamine mesylate), clinicians should be alert to the signs and symptoms of these events, particularly in patients with a history of cardiovascular disease. Following parenteral use of phentolamine at doses between 5 to 15 times higher than the recommended dose of OraVerse, myocardial infarction, and cerebrovascular spasm and occlusion have been reported, usually in association with marked hypotensive episodes producing shock-like states.

1 Median time to recovery of normal sensation was reduced by 85 minutes (55%) in the mandible and by 83 minutes (62%) in the maxilla compared to control. Median time to recovery of normal function was reduced by 60 minutes (50%) in the mandible and by 45 minutes (43%) in the maxilla.

Other Services

Other services that we provide are root canals (endodontics), extractions (tooth removal), complete dentures and partial dentures, all cosmetic dental procedures, and general dental emergencies.