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Robert C. Clay, Jr., DDS, Ltd.

Frequently Asked Questions (FAQs)

How can we help you?

If you’ve got questions, we’ve got answers. We know that most people have questions about their dental health, the services we offer, and dental insurance. We get asked questions about these topics, and many others, every single day. We welcome all of your questions, and it is an encouraging sign that you are taking interest in your oral healthcare. We would love the opportunity to help.

So, whether you have a dental question, an insurance question, or heck, if you can’t remember the lyrics to a song, we will do our best to help you get the answers you are looking for. We have a few of the more common questions compiled here, but please feel free to ask us if you have any other questions you need answered.

Other

Are dental amalgams, also known as “silver fillings” safe?  There has been a lot of debate through the years on the safety of amalgams due to their high mercury content within the material.  Mercury is a metal that is naturally formed in the earth. There have been several health related problems associated with high dose or chronic exposure to mercury. However, certain forms of mercury are more dangerous than others.  In fact, elemental and methylmercury are the two main forms that are associated with the dangers.  Other forms of mercury, such as ethylmercury or mercury in its alloy state are thought to be not as problematic.  

 

While I could present a lot of science behind the findings, I will save you the boredom and say that the following groups have found dental amalgams to be safe based on available scientific studies:  Alzheimer’s Association, International Journal of Dentistry, the Lupus Foundation of America, the Mayo Clinic, the National Multiple Sclerosis Society, the National Council Against Health Fraud, The National Institute of Dental and Craniofacial  Research, the New England Journal of Medicine, the U.S Food and Drug Administration,  and  ( everyone’s favorite web source to self diagnose) WebMD. You can get more information here from the American Dental Association website by clicking HERE.  

 

On a side note, one of the most prevalent ways to be exposed to the dangerous mercury is by eating seafood.  Fish filter mercury in the water and it is incorporated into the fish we may eat....and this is in the Methylated form that is dangerous. 

 

Should we have the old fillings removed anyways?  This is always a debate as well.  Cutting on the fillings produces heat, which results in mercury vapor, which is one of the more toxic forms of mercury. Therefore, some think removing them could be riskier than leaving them, while others worry about long term low level leakage of mercury from the fillings.  Again, science says they are safe to use and removal when needed poses little risk as well. 

 

Our thoughts: we feel confident that it is a safe material to use for dental restorations and do use it on occasion when we feel it is the best, or sometimes only material that will work.  However, we also feel it is good to limit potential exposures to mercury if there are other safer materials to use.  The removal of mercury fillings has long been linked to the increase in mercury levels in our waterways, so reducing the use of amalgam fillings is still probably a good idea overall.

 

 

It is always a good question to ask whether your child should see a pediatric dentist or whether a general dentist, like Dr. Clay would be a good fit.  As with adults, one of our biggest goals is to make every dental experience be as pleasant as possible. When it comes to children, we don’t want to make too broad of a recommendation without knowing the child and their needs.  While some kids are eager to come to the dentist, others are very fearful.  While some kids need little to  no dental work, others may need more extensive or specialty restorative treatments.  We always leave the option up to the parents to decide whether to start with our office, or to start with a pediatric office.  If they choose to come to us first, then we will evaluate the child and their needs, and decide whether it would be best suited for treatment in our office, or if they would benefit by going to a pediatric dentist.   Pediatric dentists have advanced training on treating children and can offer more extensive treatment options as well as various options for sedation when necessary. In the end, we want every experience to be a positive one.

 

 

Through the years, one of the questions that I have been asked the most is whether you should brush first or floss first.  I was always happy when people would ask that question because it made me realize that some people actually do floss at home. However, I never really had a good answer for that question. I would always say that if you flossed first, the spaces between the teeth would be cleaner for the fluoride toothpaste to penetrate between the teeth. But then I would say that if you brushed first, you would have the fluoride toothpaste in your mouth from brushing and the floss would pull the fluoride toothpaste between the teeth where a brush can't reach. And then I would sum it up by saying that there are probably benefits either way and it probably doesn’t matter that much which is done first.  I would always say that I was just happy that patients were attempting to floss

However, in May 2018 there was a research article published in the Journal of Periodontology, the publication that focuses on the treatment of gum disease and the tissues around teeth. The focus of this research article was to determine whether there was an advantage to brushing first or flossing first. The research concentrated on the reduction of plaque bacteria, the cause of gum disease and tooth decay, as well as fluoride retention on the tooth surfaces after either brushing first or flossing first. 

What they found was that flossing before you brush resulted in a statistically significant  reduction of plaque bacteria between teeth when compared to flossing after brushing.  So, that meant that flossing first did a better job of cleaning teeth in the research. In addition, flossing first also resulted in a statically significant increase in the amount of fluoride retained on the surfaces between teeth when compared to flossing after brushing. So, again, it is better to floss first because the teeth are left with more fluoride on them to help fight decay.  Here is a link to a summary of the article  https://www.perio.org/consumer/brush-or-floss-first

So now we have an answer based on science. 

It is better to floss BEFORE you brush your teeth.


 

Before you get the answer, you should know the history. This is a recommendation that changed back in 2014.  Prior to 2014, it was not recommended to use fluoride toothpaste in children under the age of 2.  Because small children don’t know how to spit out toothpaste, the fear was that they would ingest the fluoride, which would possibly lead to fluorosis.  Fluorosis is a discoloration in the teeth due to too much fluoride being deposited in the tooth crystals as teeth form.  They recommended brushing with water, or one of the training toothpastes that have no fluoride. Then from 2 to 6 years old, a pea sized application of fluoride toothpaste was recommended, and children should spit out excess paste as soon as they are capable.  

 

But in 2014, clinical research prompted changes to these recommendations.  Yes fluorosis was still a concern, but so was the higher rates of decay when fluoride was not used.  The research found that using a small smear of fluoride toothpaste, about the size of a grain of rice, would be enough to help prevent decay, yet not so much that it would result in fluorosis in most cases, even when swallowed.  Then from the ages of 3 to 6, a pea sized application of fluoride toothpaste should be used because children at that age are more capable of spitting out the extra paste.  

 

So, the answer is, you should use a rice sized smear of fluoride toothpaste from the time the first tooth erupts until age three, and then from three to six, a pea sized application is recommended.

X-rays are a dentist's most important diagnostic tool. Often, problems start inside your teeth or beneath the gumline. By the time the problem is visible to the naked eye, it can be painful and more difficult to treat. Using x-rays taken on a regular basis, we can catch problems early and treat them quickly and comfortably.

Cleaning and Exam

The use of dental X-rays has been a vital component of the diagnostic capabilities in dentistry since they were first invented.   While the first x-ray systems required a lot of radiation to produce relatively poor quality images, modern digital (computer based) x-ray sensors require only a fraction of the radiation that was needed by early X-rays and produce very detailed images that can be manipulated on the computer.  We use these low dose X-rays in our office to produce the best and safest radiographic images possible. To answer the question as to how often you should get X-rays, there are several factors to consider.  First off, there is a general guideline of recommended intervals that has been presented by the American Dental Association.  Second, there is a frequency limitation established by insurance companies.  I will start with the insurance limitations and say that insurance companies each have their own guidelines for the frequency that they will cover X-rays, and we always try to adhere to these limitations so out of pocket costs are minimized; however, the insurance limitations may not be appropriate for every patient’s needs.  Insurance companies are businesses and they help pay for dental treatment, but they don’t always pay for the treatment that best fits your case.  Therefore, it is important to consider what is best instead of what is covered. The ADA’s recommendations are a set of guidelines to use to determine how often X-rays should be taken on adolescents as well as adults.  We use these guidelines to help determine when, which, and how many X-rays should be taken. 

 

Routine screening X-rays are useful tools to help us catch problems at the earliest stages. It is important for us to utilize them even when there is no obvious problems or pain that a patient may feel. Because every patient’s needs and history is different, we evaluate each patient to determine what is right for them.  When there is a history of decay, or recent active decay, we may opt to take X-rays more often so we can catch problems in their early stages.  On the other hand, for those with little or no decay, we may take X-rays less often. It is still important, however, to take X-rays so that not only tooth decay can be found at its earliest stages, but also to detect signs of periodontal disease, abscesses in teeth and bone, cysts, cancerous tumors, or many other abnormalities that are better caught at early stages. 

 

Like most things in life, X-rays are not a one size fits all tool, and we will customize our recommendations to meet your needs.  We are always happy to see you to discuss this and help you keep your healthy and happy smile

 

Through the years, one of the questions that I have been asked the most is whether you should brush first or floss first.  I was always happy when people would ask that question because it made me realize that some people actually do floss at home. However, I never really had a good answer for that question. I would always say that if you flossed first, the spaces between the teeth would be cleaner for the fluoride toothpaste to penetrate between the teeth. But then I would say that if you brushed first, you would have the fluoride toothpaste in your mouth from brushing and the floss would pull the fluoride toothpaste between the teeth where a brush can't reach. And then I would sum it up by saying that there are probably benefits either way and it probably doesn’t matter that much which is done first.  I would always say that I was just happy that patients were attempting to floss

However, in May 2018 there was a research article published in the Journal of Periodontology, the publication that focuses on the treatment of gum disease and the tissues around teeth. The focus of this research article was to determine whether there was an advantage to brushing first or flossing first. The research concentrated on the reduction of plaque bacteria, the cause of gum disease and tooth decay, as well as fluoride retention on the tooth surfaces after either brushing first or flossing first. 

What they found was that flossing before you brush resulted in a statistically significant  reduction of plaque bacteria between teeth when compared to flossing after brushing.  So, that meant that flossing first did a better job of cleaning teeth in the research. In addition, flossing first also resulted in a statically significant increase in the amount of fluoride retained on the surfaces between teeth when compared to flossing after brushing. So, again, it is better to floss first because the teeth are left with more fluoride on them to help fight decay.  Here is a link to a summary of the article  https://www.perio.org/consumer/brush-or-floss-first

So now we have an answer based on science. 

It is better to floss BEFORE you brush your teeth.

Toothbrush | from unsplashIt’s a pretty common question we get. It makes sense that a hard bristled brush would do a better job scrubbing your teeth, right?  However, the recommendation is to always use a soft bristled brush. 

 

The bacterial plaque and food debris that we aim to remove is a thin gel that is lightly attached to your teeth.  It comes off relatively easily with soft bristles.  While the stiffer bristles would remove it as well, the stiffer bristles can be stiff enough to damage your teeth.  

 

As an example, if you scrub a spot on your floor every day, twice a day, with a wire brush, it will quickly wear away a hole in the floor. On the other hand, a soft brush is much less likely to wear the floor away. The same holds for teeth. Harder bristles will damage teeth over time. 

 

What about tartar or calculus?

 

While tartar and calculus are harder buildups that are stuck on teeth, even the firm bristle brushes won’t remove it.  This is why you need to get your teeth professionally cleaned with the sharp instruments that can chip these buildups off your teeth.  Give us a call if it is time to get them professionally cleaned.  Your teeth will thank you for it. 


 

Before you get the answer, you should know the history. This is a recommendation that changed back in 2014.  Prior to 2014, it was not recommended to use fluoride toothpaste in children under the age of 2.  Because small children don’t know how to spit out toothpaste, the fear was that they would ingest the fluoride, which would possibly lead to fluorosis.  Fluorosis is a discoloration in the teeth due to too much fluoride being deposited in the tooth crystals as teeth form.  They recommended brushing with water, or one of the training toothpastes that have no fluoride. Then from 2 to 6 years old, a pea sized application of fluoride toothpaste was recommended, and children should spit out excess paste as soon as they are capable.  

 

But in 2014, clinical research prompted changes to these recommendations.  Yes fluorosis was still a concern, but so was the higher rates of decay when fluoride was not used.  The research found that using a small smear of fluoride toothpaste, about the size of a grain of rice, would be enough to help prevent decay, yet not so much that it would result in fluorosis in most cases, even when swallowed.  Then from the ages of 3 to 6, a pea sized application of fluoride toothpaste should be used because children at that age are more capable of spitting out the extra paste.  

 

So, the answer is, you should use a rice sized smear of fluoride toothpaste from the time the first tooth erupts until age three, and then from three to six, a pea sized application is recommended.

Coming in for regular cleanings with one of our excellent dental hygienists will help keep your gums in great shape, but what you do at home matters as well. Brush twice daily and floss every evening. Our hygienists will be happy to show you good brushing and flossing technique.

Other steps you can take to prevent gum disease include:

  • Don't smoke or chew tobacco
  • Eat a healthy diet full of fresh fruits and vegetables
  • Use an antiseptic mouthwash. We'll be happy to recommend one.
  • If you have a health condition that can affect your dental health such as diabetes, heart disease, or cancer, please let us know so that we can take extra steps to help keep your gums healthy.

Examinations are an important opportunity for us to check in with you, see how you are doing, and make sure that your teeth are healthy. We want to catch problems when they are small and can be treated easily. This allows for more comfortable and less costly dentistry for you. Unfortunately, by the time you are in pain, simple measures are no longer effective. Regular examinations allow us to nip this situation in the bud and keep your teeth healthy and beautiful.

X-rays are a dentist's most important diagnostic tool. Often, problems start inside your teeth or beneath the gumline. By the time the problem is visible to the naked eye, it can be painful and more difficult to treat. Using x-rays taken on a regular basis, we can catch problems early and treat them quickly and comfortably.

Cosmetic Dentistry

Invisalign is a popular and amazing option to help straighten your teeth and improve the way you can bite.  It is popular because it moves teeth without using the unsightly brackets and wires of traditional braces.  We love Invisalign, and Invisalign can address quite a few orthodontic cases very impressively, but Invisalign may not be the best way to go in some instances. Sometimes conventional braces are needed.  Sometimes, more advanced Invisalign treatments are required.  As in any treatment option that may have multiple options, we will evaluate your problems and discuss the pros and cons of the various options. If it is an Invisalign case that we feel comfortable treating, we can move forward with your case in our office.  If Invisalign isn’t a good option, or if it is a more advanced Invisalign case, we will refer you to an orthodontist so you get the best treatment possible. 

 

A simple answer is....sometimes.  The truth is that every implant case is so different that the options are based on the patient’s needs as well as the existing conditions.  With individual implants to replace single teeth, the tooth root shape and the implant shape are relatively similar, so we have a better chance to have the option to place an implant the same day the tooth is removed. For multi rooted back teeth, it isn’t as easy, or even possible to do same day implant placement due to the different shapes of a cylinder implant versus a multi rooted tooth shape. Other variables like bone shape, infection, or other health issues also come into play with immediate implant placement. I always tell patients that we don’t want to rush to do things wrong.  It is always better to do it right the first time, and although immediate placement may be desired, it isn’t always a good idea.

 

There are a lot of tv ads about getting implants done as well as “teeth in a day.”  To learn more about this particular implant option, click HERE

There are various reasons we do crowns as well as various processes involved.  Most of the time, after a tooth is prepared and an impression taken, we can have the crown ready to cement in two weeks.  Crowns on implants will often require an additional week to make as implant components must be ordered by the lab and custom parts fabricated.  Those additional steps require more time at the lab. 

 

There are other times that the time frame may differ for various reasons.  Sometimes we like to keep a temporary crown on, or even the permanent crown, using temporary cement for an extended period. We will do this when we have concerns about the health of the nerve in the tooth and we want additional time to evaluate it.  If we need the lab to make a post for the tooth, this will also require additional time and appointments. Other times, we will send you to the lab so the lab technician can see you for custom shading and tinting so the best esthetic result can be obtained.  Timing of that appointment and availability of the patient and lab technician may delay the final finish date accordingly.

 

Like so many things, we want them done right, not just fast.  We understand that patients want things done right away, but we want them done right. We will always go the extra mile to make sure you get the result you want and deserve. 

We offer a range of cosmetic dentistry services such as veneers, porcelain crowns, bonding using tooth-colored composite, and even orthodontic treatments like Invisalign. All our of dentistry is done with an eye toward aesthetics. We know that it's important that your teeth are both healthy and attractive. If you'd like to find out which of our services can help you meet your goals, call our office to schedule your consultation.

When people have chipped or worn teeth, it can result in esthetic concerns as well as produce discomfort of the teeth or joints. While patients want things fixed quickly, our first challenge is to determine the cause of the problem.  We always want to know the cause because we want to prevent further breakdown of the teeth, as well as have long term success with any new restorations we may place.  Sometimes the fix can be as simple as a filling, a crown or a veneer,  while other times the optimal treatment may get more involved. We often see an underlying cause of tooth breakdown related to grinding or clenching teeth. When there is significant wear throughout, the restorative treatment to address this problem may involve a full rehabilitation of crowns on many, or even all teeth to re establish a normal alignment of the teeth.  Other times we see an underlying cause that is orthodontic in nature and we need to treat the patient with orthodontics such as braces or Invisalign prior to any restorations.  So, our “cosmetic” options will be determined by the problems we are presented with, and we will always show our patients X-rays, photos, and plaster models to explain our findings and recommendations prior to starting any treatment. If you have any concerns with chipping or wear, give us a call so we can see what options you may have to restore your optimal smile. 

When patients talk about “cosmetic dentistry” we are always interested to hear what people think that means.  To us, dentistry has evolved to the point that we feel most services could be considered “cosmetic” as we use tooth colored filling material for almost everything.  That said, many people consider cosmetic dentistry to include the use of porcelain crowns, porcelain veneers, bonded white fillings on front teeth, tooth whitening or bleaching, and white fillings on back teeth.  And yes, we routinely perform all of these procedures.  We also utilize Invisalign to help straighten your teeth,  and dental implant restorations to restore a single tooth, multiple teeth, or even all of your teeth.  In fact, we even feel the conventional dentures and removable partials we fabricate also fall into the cosmetic category as we not only use top labs and materials, but also take every extra step to ensure they look as realistic as possible.  So yes, we do perform all of these cosmetic dental services, and we will discuss them with you, as well as present options and risks of treatment before we start your treatment. Give us a call to set up a consultation so we can see what can be done.

It seems like a simple question, but there isn't always one simple answer.  In order to answer that question, we would want to see you in our office so we could evaluate your overall oral health because any treatment is doomed to fail if the gums are not healthy enough to support the treatments.  Once we evaluate your periodontal (gum) health, we will evaluate your tooth health and determine which treatments are necessary.  We always  have to consider both form and function.  In other words, we not only want it to look right (form) but we want it to function.  Sometimes we may recommend orthodontic treatment prior to any restorative treatments.  Other times, something as simple as bleaching teeth is all that is needed to make things look brighter. Most of the time, the needs fall somewhere in between.  The best way to get an answer is to give us a call so we can see what you need, what you want, and then come up with a list of options based on your mouth and your wishes.  Give us a call so we can come up with a treatment plan that will fit your needs. 

We make every effort to select the best materials for your restorative needs. There are many options available for crowning teeth.  While gold teeth are often considered an older, not so esthetic option, they are still one of the best materials that can be used in dentistry. 

 

That said, most patients prefer the white crowns that look like real teeth.  The traditional Porcelain Fused to Metal (PFM) crowns have been widely used with great success in dentistry.  These PFM crowns can be made to look very realistic in most cases, but they are what we call “feldspathic porcelain” and this material’s biggest drawback is its low fracture toughness,  essentially, it can crack and chip easily. It also requires quite a bit of tooth to be cut away in order to use as directed. 

 

Lithium disilicate crowns are a newer option that is also highly esthetic.  This material has no metal substructure to hide and it also has a much higher fracture toughness than the PFM crowns.  This material also requires aggressive tooth prepping to use properly.

 

Zirconia is a newer material that is our strongest yet.  It is extremely strong and ther is no metal to hide.  Another benefit is the conservative tooth preparation that can be done to use this material.  The downside is that it is not as pretty of a material.  I looks good, but not great.  The manufacturers have developed even newer versions of this material that are starting to look much more like the other materials as far as esthetics, but the strength drops greatly with these options; however it is still much stronger than the traditional PFM crowns.

 

We choose the material we use based on needs.  Location plays a big role as back teeth do more work and would benefit from more strength, while front teeth don’t do as much of a chewing load, but are required to look good.  As fear as strength goes, the flexural strength (force to break the material) of a PFM is 90 MPa (MegaPascals), lithium disilicate is 400 MPa, and the strongest. Zirconia is 1465 MPa. You don’t have to understand the physics behind flexural strength or megapascals, but it is easy to understand that 1465 is more than 90. Since MPa is a unit of force needed to break the material,  zirconia is exponentially stronger for back teeth and is often used as we like the braun over the beauty. Lithium disilicate or PFM crowns are used more in front for beauty.  We also use labs that can custom tint crowns to get your shade as exact as possible.  We will make sure you are happy with the result you get.

Crowns and Bridges

There are various reasons we do crowns as well as various processes involved.  Most of the time, after a tooth is prepared and an impression taken, we can have the crown ready to cement in two weeks.  Crowns on implants will often require an additional week to make as implant components must be ordered by the lab and custom parts fabricated.  Those additional steps require more time at the lab. 

 

There are other times that the time frame may differ for various reasons.  Sometimes we like to keep a temporary crown on, or even the permanent crown, using temporary cement for an extended period. We will do this when we have concerns about the health of the nerve in the tooth and we want additional time to evaluate it.  If we need the lab to make a post for the tooth, this will also require additional time and appointments. Other times, we will send you to the lab so the lab technician can see you for custom shading and tinting so the best esthetic result can be obtained.  Timing of that appointment and availability of the patient and lab technician may delay the final finish date accordingly.

 

Like so many things, we want them done right, not just fast.  We understand that patients want things done right away, but we want them done right. We will always go the extra mile to make sure you get the result you want and deserve. 

We offer a range of cosmetic dentistry services such as veneers, porcelain crowns, bonding using tooth-colored composite, and even orthodontic treatments like Invisalign. All our of dentistry is done with an eye toward aesthetics. We know that it's important that your teeth are both healthy and attractive. If you'd like to find out which of our services can help you meet your goals, call our office to schedule your consultation.

Having a missing tooth can be very stressful when considering esthetics, the treatment one needs to undergo to replace the tooth, or teeth, and the costs associated.  Since every patient has their own individual needs as well as financial constraints, it is not always up to us to decide what is “best” for you. We will always present all of the available options and weigh the pros and cons as far as optimal dental treatment goes.  Along with that, we will present the fees associated with all of these options.  Finally, we will present you with options for third party finance companies to help spread the costs over a longer period of time where costs are a concern.  We will try to find a way to allow you to get the best treatment, the treatment that you deserve, but also understand if the “best” treatment just isn’t feasible at this time.  We will then work to help you decide on one of the alternate options

When people have chipped or worn teeth, it can result in esthetic concerns as well as produce discomfort of the teeth or joints. While patients want things fixed quickly, our first challenge is to determine the cause of the problem.  We always want to know the cause because we want to prevent further breakdown of the teeth, as well as have long term success with any new restorations we may place.  Sometimes the fix can be as simple as a filling, a crown or a veneer,  while other times the optimal treatment may get more involved. We often see an underlying cause of tooth breakdown related to grinding or clenching teeth. When there is significant wear throughout, the restorative treatment to address this problem may involve a full rehabilitation of crowns on many, or even all teeth to re establish a normal alignment of the teeth.  Other times we see an underlying cause that is orthodontic in nature and we need to treat the patient with orthodontics such as braces or Invisalign prior to any restorations.  So, our “cosmetic” options will be determined by the problems we are presented with, and we will always show our patients X-rays, photos, and plaster models to explain our findings and recommendations prior to starting any treatment. If you have any concerns with chipping or wear, give us a call so we can see what options you may have to restore your optimal smile. 

A dental crown, also referred to as a cap, is a restorative option to restore a single tooth into function and also provide esthetics in the esthetic zone. There are many reasons to place a crown, but the basic process involves a dentist, or laboratory modifying and contouring a tooth, or implant component, so that a fake tooth (crown) can fit over it and glued into place.  I always compare it to placing a thimble over a finger.  Crowns can be made of esthetic materials to match adjacent teeth, or gold.  There are benefits to each material option and we will discuss this with our patients as we  are planning the restoration.  If you think you need a crown, we would be happy to discuss it with you further, so give us a call for a consultation. 

Crowns, often called caps, and bridges are ways to restore teeth into function.  Crowns are restorations placed on a single tooth or implant to return it into function.  A bridge, on the other hand is used to replace a missing tooth or teeth by “bridging” the space that is missing teeth using artificially fabricated teeth. We do this by fabricating a restoration that has several teeth connected together and we anchor this restoration, also known as a “bridge,” to existing teeth that are modified to act as anchors.   The most common materials used for these restorations are either gold, porcelain, lithium disilicate, or zirconia.  There are other materials available, but these are the ones we most commonly use. There are benefits and drawbacks of each material option and we always weigh esthetics and strength as deciding factors when selecting materials for our patients. If you feel you need a crown or bridge, contact us so we can give you an evaluation and see what your options may be.   

When patients talk about “cosmetic dentistry” we are always interested to hear what people think that means.  To us, dentistry has evolved to the point that we feel most services could be considered “cosmetic” as we use tooth colored filling material for almost everything.  That said, many people consider cosmetic dentistry to include the use of porcelain crowns, porcelain veneers, bonded white fillings on front teeth, tooth whitening or bleaching, and white fillings on back teeth.  And yes, we routinely perform all of these procedures.  We also utilize Invisalign to help straighten your teeth,  and dental implant restorations to restore a single tooth, multiple teeth, or even all of your teeth.  In fact, we even feel the conventional dentures and removable partials we fabricate also fall into the cosmetic category as we not only use top labs and materials, but also take every extra step to ensure they look as realistic as possible.  So yes, we do perform all of these cosmetic dental services, and we will discuss them with you, as well as present options and risks of treatment before we start your treatment. Give us a call to set up a consultation so we can see what can be done.

We make every effort to select the best materials for your restorative needs. There are many options available for crowning teeth.  While gold teeth are often considered an older, not so esthetic option, they are still one of the best materials that can be used in dentistry. 

 

That said, most patients prefer the white crowns that look like real teeth.  The traditional Porcelain Fused to Metal (PFM) crowns have been widely used with great success in dentistry.  These PFM crowns can be made to look very realistic in most cases, but they are what we call “feldspathic porcelain” and this material’s biggest drawback is its low fracture toughness,  essentially, it can crack and chip easily. It also requires quite a bit of tooth to be cut away in order to use as directed. 

 

Lithium disilicate crowns are a newer option that is also highly esthetic.  This material has no metal substructure to hide and it also has a much higher fracture toughness than the PFM crowns.  This material also requires aggressive tooth prepping to use properly.

 

Zirconia is a newer material that is our strongest yet.  It is extremely strong and ther is no metal to hide.  Another benefit is the conservative tooth preparation that can be done to use this material.  The downside is that it is not as pretty of a material.  I looks good, but not great.  The manufacturers have developed even newer versions of this material that are starting to look much more like the other materials as far as esthetics, but the strength drops greatly with these options; however it is still much stronger than the traditional PFM crowns.

 

We choose the material we use based on needs.  Location plays a big role as back teeth do more work and would benefit from more strength, while front teeth don’t do as much of a chewing load, but are required to look good.  As fear as strength goes, the flexural strength (force to break the material) of a PFM is 90 MPa (MegaPascals), lithium disilicate is 400 MPa, and the strongest. Zirconia is 1465 MPa. You don’t have to understand the physics behind flexural strength or megapascals, but it is easy to understand that 1465 is more than 90. Since MPa is a unit of force needed to break the material,  zirconia is exponentially stronger for back teeth and is often used as we like the braun over the beauty. Lithium disilicate or PFM crowns are used more in front for beauty.  We also use labs that can custom tint crowns to get your shade as exact as possible.  We will make sure you are happy with the result you get.

Dental Implants

A simple answer is....sometimes.  The truth is that every implant case is so different that the options are based on the patient’s needs as well as the existing conditions.  With individual implants to replace single teeth, the tooth root shape and the implant shape are relatively similar, so we have a better chance to have the option to place an implant the same day the tooth is removed. For multi rooted back teeth, it isn’t as easy, or even possible to do same day implant placement due to the different shapes of a cylinder implant versus a multi rooted tooth shape. Other variables like bone shape, infection, or other health issues also come into play with immediate implant placement. I always tell patients that we don’t want to rush to do things wrong.  It is always better to do it right the first time, and although immediate placement may be desired, it isn’t always a good idea.

 

There are a lot of tv ads about getting implants done as well as “teeth in a day.”  To learn more about this particular implant option, click HERE

There are various reasons we do crowns as well as various processes involved.  Most of the time, after a tooth is prepared and an impression taken, we can have the crown ready to cement in two weeks.  Crowns on implants will often require an additional week to make as implant components must be ordered by the lab and custom parts fabricated.  Those additional steps require more time at the lab. 

 

There are other times that the time frame may differ for various reasons.  Sometimes we like to keep a temporary crown on, or even the permanent crown, using temporary cement for an extended period. We will do this when we have concerns about the health of the nerve in the tooth and we want additional time to evaluate it.  If we need the lab to make a post for the tooth, this will also require additional time and appointments. Other times, we will send you to the lab so the lab technician can see you for custom shading and tinting so the best esthetic result can be obtained.  Timing of that appointment and availability of the patient and lab technician may delay the final finish date accordingly.

 

Like so many things, we want them done right, not just fast.  We understand that patients want things done right away, but we want them done right. We will always go the extra mile to make sure you get the result you want and deserve. 

Having a missing tooth can be very stressful when considering esthetics, the treatment one needs to undergo to replace the tooth, or teeth, and the costs associated.  Since every patient has their own individual needs as well as financial constraints, it is not always up to us to decide what is “best” for you. We will always present all of the available options and weigh the pros and cons as far as optimal dental treatment goes.  Along with that, we will present the fees associated with all of these options.  Finally, we will present you with options for third party finance companies to help spread the costs over a longer period of time where costs are a concern.  We will try to find a way to allow you to get the best treatment, the treatment that you deserve, but also understand if the “best” treatment just isn’t feasible at this time.  We will then work to help you decide on one of the alternate options

Dental implants have several advantages over other tooth replacement options:

  • Dental implants appear the most life-like and natural.
  • The actual implant piece of the dental implant is made of titanium, a biocompatible metal.
  • Dental implants are the most secure and stable.
  • Dental implants prevent bone loss, keeping your jaw tissue healthy and preventing changes in the shape of your face.
  • With proper care, dental implants can last a lifetime.

Dentures and partials are both treatment options that utilize removable prosthetics to replace missing teeth.  Full dentures replace all of the teeth when they are all missing, while partial dentures are used when some natural teeth remain and we need to replace the missing natural teeth with artificial teeth. Traditionally, both of these options involve prosthetics that the patient can take in and out of their mouth by themselves in order to clean them; however, modern dentistry also allows us to present options with implants. Utilizing implants we can now fabricate dentures or partials that the patient can take in and out of their own mouth by clipping onto implant attachments, as well as options that involve screwing the teeth into the implants where the patient cannot remove the teeth by themselves.  Give us a call to see which options are available to you.

When patients talk about “cosmetic dentistry” we are always interested to hear what people think that means.  To us, dentistry has evolved to the point that we feel most services could be considered “cosmetic” as we use tooth colored filling material for almost everything.  That said, many people consider cosmetic dentistry to include the use of porcelain crowns, porcelain veneers, bonded white fillings on front teeth, tooth whitening or bleaching, and white fillings on back teeth.  And yes, we routinely perform all of these procedures.  We also utilize Invisalign to help straighten your teeth,  and dental implant restorations to restore a single tooth, multiple teeth, or even all of your teeth.  In fact, we even feel the conventional dentures and removable partials we fabricate also fall into the cosmetic category as we not only use top labs and materials, but also take every extra step to ensure they look as realistic as possible.  So yes, we do perform all of these cosmetic dental services, and we will discuss them with you, as well as present options and risks of treatment before we start your treatment. Give us a call to set up a consultation so we can see what can be done.

When dental implants, or any restorative option for that matter, are used, we make every effort to make your dental work blend in and look as natural as possible. The implant surgeons take great care and planning to place implants in a location that will not only be functional, but also allow us to make things looks as natural as possible.  In most cases, it is difficult to impossible for other people to identify the use of an implant.  There are times, however, where we may have challenges to what we want to do based on various factors.  In these cases where we may have compromises, including esthetics, we will always try to discuss these challenges prior to treatment. That said, there are many ways we can make things look natural, even in the most difficult cases.  The best way is to let us see you so we can evaluate your needs and then we can come up with a restorative plan with all of the options available.

Dentures and Partials

Having a missing tooth can be very stressful when considering esthetics, the treatment one needs to undergo to replace the tooth, or teeth, and the costs associated.  Since every patient has their own individual needs as well as financial constraints, it is not always up to us to decide what is “best” for you. We will always present all of the available options and weigh the pros and cons as far as optimal dental treatment goes.  Along with that, we will present the fees associated with all of these options.  Finally, we will present you with options for third party finance companies to help spread the costs over a longer period of time where costs are a concern.  We will try to find a way to allow you to get the best treatment, the treatment that you deserve, but also understand if the “best” treatment just isn’t feasible at this time.  We will then work to help you decide on one of the alternate options

Dentures and partials are both treatment options that utilize removable prosthetics to replace missing teeth.  Full dentures replace all of the teeth when they are all missing, while partial dentures are used when some natural teeth remain and we need to replace the missing natural teeth with artificial teeth. Traditionally, both of these options involve prosthetics that the patient can take in and out of their mouth by themselves in order to clean them; however, modern dentistry also allows us to present options with implants. Utilizing implants we can now fabricate dentures or partials that the patient can take in and out of their own mouth by clipping onto implant attachments, as well as options that involve screwing the teeth into the implants where the patient cannot remove the teeth by themselves.  Give us a call to see which options are available to you.

When patients talk about “cosmetic dentistry” we are always interested to hear what people think that means.  To us, dentistry has evolved to the point that we feel most services could be considered “cosmetic” as we use tooth colored filling material for almost everything.  That said, many people consider cosmetic dentistry to include the use of porcelain crowns, porcelain veneers, bonded white fillings on front teeth, tooth whitening or bleaching, and white fillings on back teeth.  And yes, we routinely perform all of these procedures.  We also utilize Invisalign to help straighten your teeth,  and dental implant restorations to restore a single tooth, multiple teeth, or even all of your teeth.  In fact, we even feel the conventional dentures and removable partials we fabricate also fall into the cosmetic category as we not only use top labs and materials, but also take every extra step to ensure they look as realistic as possible.  So yes, we do perform all of these cosmetic dental services, and we will discuss them with you, as well as present options and risks of treatment before we start your treatment. Give us a call to set up a consultation so we can see what can be done.

We always make every effort to make dentures and partials, as well as any other restoration, disappear and look natural in the mouth.  We use premium brand tooth manufacturers to get the most natural esthetic results, and always try to design the prosthetics to maximize esthetics.  That said, there are occasions where options available may make it more difficult to completely hide the fact that they are dentures, or more often partials.  We always use extra appointments to verify esthetic satisfaction prior to final fabrication. This allows our patients to give final approval before final processing.  We often find that the biggest challenge to the dentures and partials looking real is the fact that patients often want teeth that are too white and too perfectly set. When doing our setup, we will discuss this with our patients prior to selecting the desired shade of teeth and doing our setup.  We always work with our patients and lab to deliver the final result that patients desire.  If you need a denture or partial, give us a call to see what we can do for you. 

Family Dentistry

It is always a good question to ask whether your child should see a pediatric dentist or whether a general dentist, like Dr. Clay would be a good fit.  As with adults, one of our biggest goals is to make every dental experience be as pleasant as possible. When it comes to children, we don’t want to make too broad of a recommendation without knowing the child and their needs.  While some kids are eager to come to the dentist, others are very fearful.  While some kids need little to  no dental work, others may need more extensive or specialty restorative treatments.  We always leave the option up to the parents to decide whether to start with our office, or to start with a pediatric office.  If they choose to come to us first, then we will evaluate the child and their needs, and decide whether it would be best suited for treatment in our office, or if they would benefit by going to a pediatric dentist.   Pediatric dentists have advanced training on treating children and can offer more extensive treatment options as well as various options for sedation when necessary. In the end, we want every experience to be a positive one.

 

The use of dental X-rays has been a vital component of the diagnostic capabilities in dentistry since they were first invented.   While the first x-ray systems required a lot of radiation to produce relatively poor quality images, modern digital (computer based) x-ray sensors require only a fraction of the radiation that was needed by early X-rays and produce very detailed images that can be manipulated on the computer.  We use these low dose X-rays in our office to produce the best and safest radiographic images possible. To answer the question as to how often you should get X-rays, there are several factors to consider.  First off, there is a general guideline of recommended intervals that has been presented by the American Dental Association.  Second, there is a frequency limitation established by insurance companies.  I will start with the insurance limitations and say that insurance companies each have their own guidelines for the frequency that they will cover X-rays, and we always try to adhere to these limitations so out of pocket costs are minimized; however, the insurance limitations may not be appropriate for every patient’s needs.  Insurance companies are businesses and they help pay for dental treatment, but they don’t always pay for the treatment that best fits your case.  Therefore, it is important to consider what is best instead of what is covered. The ADA’s recommendations are a set of guidelines to use to determine how often X-rays should be taken on adolescents as well as adults.  We use these guidelines to help determine when, which, and how many X-rays should be taken. 

 

Routine screening X-rays are useful tools to help us catch problems at the earliest stages. It is important for us to utilize them even when there is no obvious problems or pain that a patient may feel. Because every patient’s needs and history is different, we evaluate each patient to determine what is right for them.  When there is a history of decay, or recent active decay, we may opt to take X-rays more often so we can catch problems in their early stages.  On the other hand, for those with little or no decay, we may take X-rays less often. It is still important, however, to take X-rays so that not only tooth decay can be found at its earliest stages, but also to detect signs of periodontal disease, abscesses in teeth and bone, cysts, cancerous tumors, or many other abnormalities that are better caught at early stages. 

 

Like most things in life, X-rays are not a one size fits all tool, and we will customize our recommendations to meet your needs.  We are always happy to see you to discuss this and help you keep your healthy and happy smile

Having a missing tooth can be very stressful when considering esthetics, the treatment one needs to undergo to replace the tooth, or teeth, and the costs associated.  Since every patient has their own individual needs as well as financial constraints, it is not always up to us to decide what is “best” for you. We will always present all of the available options and weigh the pros and cons as far as optimal dental treatment goes.  Along with that, we will present the fees associated with all of these options.  Finally, we will present you with options for third party finance companies to help spread the costs over a longer period of time where costs are a concern.  We will try to find a way to allow you to get the best treatment, the treatment that you deserve, but also understand if the “best” treatment just isn’t feasible at this time.  We will then work to help you decide on one of the alternate options


 

Before you get the answer, you should know the history. This is a recommendation that changed back in 2014.  Prior to 2014, it was not recommended to use fluoride toothpaste in children under the age of 2.  Because small children don’t know how to spit out toothpaste, the fear was that they would ingest the fluoride, which would possibly lead to fluorosis.  Fluorosis is a discoloration in the teeth due to too much fluoride being deposited in the tooth crystals as teeth form.  They recommended brushing with water, or one of the training toothpastes that have no fluoride. Then from 2 to 6 years old, a pea sized application of fluoride toothpaste was recommended, and children should spit out excess paste as soon as they are capable.  

 

But in 2014, clinical research prompted changes to these recommendations.  Yes fluorosis was still a concern, but so was the higher rates of decay when fluoride was not used.  The research found that using a small smear of fluoride toothpaste, about the size of a grain of rice, would be enough to help prevent decay, yet not so much that it would result in fluorosis in most cases, even when swallowed.  Then from the ages of 3 to 6, a pea sized application of fluoride toothpaste should be used because children at that age are more capable of spitting out the extra paste.  

 

So, the answer is, you should use a rice sized smear of fluoride toothpaste from the time the first tooth erupts until age three, and then from three to six, a pea sized application is recommended.

Examinations are an important opportunity for us to check in with you, see how you are doing, and make sure that your teeth are healthy. We want to catch problems when they are small and can be treated easily. This allows for more comfortable and less costly dentistry for you. Unfortunately, by the time you are in pain, simple measures are no longer effective. Regular examinations allow us to nip this situation in the bud and keep your teeth healthy and beautiful.

X-rays are a dentist's most important diagnostic tool. Often, problems start inside your teeth or beneath the gumline. By the time the problem is visible to the naked eye, it can be painful and more difficult to treat. Using x-rays taken on a regular basis, we can catch problems early and treat them quickly and comfortably.

Our goal is to always do what is best for you.  As a general dental office, we do perform most of the dental treatment needs our patients require. Every day, we do dental exams, cleanings, fillings, crowns, bridges dentures, implant dentistry, cosmetic dentistry, and a whole array of other treatments. We are also your source for information and answers to the questions you may have.

 

All that said, there are times where we feel your treatment will be better served by seeing a specialist. Dental specialists receive the same dental school education as every other dentist, but they continue on in their specialty program to get advanced training and experience far above the training a general dentist gets. Specialists will often have the most advanced technology in their field, and because it is all they do, they always keep up the with advances in treatment in their field. Essentially, whenever we feel a specialist can do a better job than us, we feel they should do it from the start. We don’t like to start something and then decide it should be finished by a specialist, although sometimes that happens as we are trying to treat emergencies or other unforeseen complications.  We understand that patients don’t always want to get treatment by another office, but I always say “ if you need heart surgery, do you want a cardiologist doing it, or your general family doctor?”  We always want what’s best for you.

 

So give us a call and set up an appointment so we can see what you need. We will then discuss your needs and come up with a plan together.

Invisalign

Invisalign is a popular and amazing option to help straighten your teeth and improve the way you can bite.  It is popular because it moves teeth without using the unsightly brackets and wires of traditional braces.  We love Invisalign, and Invisalign can address quite a few orthodontic cases very impressively, but Invisalign may not be the best way to go in some instances. Sometimes conventional braces are needed.  Sometimes, more advanced Invisalign treatments are required.  As in any treatment option that may have multiple options, we will evaluate your problems and discuss the pros and cons of the various options. If it is an Invisalign case that we feel comfortable treating, we can move forward with your case in our office.  If Invisalign isn’t a good option, or if it is a more advanced Invisalign case, we will refer you to an orthodontist so you get the best treatment possible. 

 

When people have chipped or worn teeth, it can result in esthetic concerns as well as produce discomfort of the teeth or joints. While patients want things fixed quickly, our first challenge is to determine the cause of the problem.  We always want to know the cause because we want to prevent further breakdown of the teeth, as well as have long term success with any new restorations we may place.  Sometimes the fix can be as simple as a filling, a crown or a veneer,  while other times the optimal treatment may get more involved. We often see an underlying cause of tooth breakdown related to grinding or clenching teeth. When there is significant wear throughout, the restorative treatment to address this problem may involve a full rehabilitation of crowns on many, or even all teeth to re establish a normal alignment of the teeth.  Other times we see an underlying cause that is orthodontic in nature and we need to treat the patient with orthodontics such as braces or Invisalign prior to any restorations.  So, our “cosmetic” options will be determined by the problems we are presented with, and we will always show our patients X-rays, photos, and plaster models to explain our findings and recommendations prior to starting any treatment. If you have any concerns with chipping or wear, give us a call so we can see what options you may have to restore your optimal smile. 

When patients talk about “cosmetic dentistry” we are always interested to hear what people think that means.  To us, dentistry has evolved to the point that we feel most services could be considered “cosmetic” as we use tooth colored filling material for almost everything.  That said, many people consider cosmetic dentistry to include the use of porcelain crowns, porcelain veneers, bonded white fillings on front teeth, tooth whitening or bleaching, and white fillings on back teeth.  And yes, we routinely perform all of these procedures.  We also utilize Invisalign to help straighten your teeth,  and dental implant restorations to restore a single tooth, multiple teeth, or even all of your teeth.  In fact, we even feel the conventional dentures and removable partials we fabricate also fall into the cosmetic category as we not only use top labs and materials, but also take every extra step to ensure they look as realistic as possible.  So yes, we do perform all of these cosmetic dental services, and we will discuss them with you, as well as present options and risks of treatment before we start your treatment. Give us a call to set up a consultation so we can see what can be done.

Periodontal Prevention and Treatment

 

Through the years, one of the questions that I have been asked the most is whether you should brush first or floss first.  I was always happy when people would ask that question because it made me realize that some people actually do floss at home. However, I never really had a good answer for that question. I would always say that if you flossed first, the spaces between the teeth would be cleaner for the fluoride toothpaste to penetrate between the teeth. But then I would say that if you brushed first, you would have the fluoride toothpaste in your mouth from brushing and the floss would pull the fluoride toothpaste between the teeth where a brush can't reach. And then I would sum it up by saying that there are probably benefits either way and it probably doesn’t matter that much which is done first.  I would always say that I was just happy that patients were attempting to floss

However, in May 2018 there was a research article published in the Journal of Periodontology, the publication that focuses on the treatment of gum disease and the tissues around teeth. The focus of this research article was to determine whether there was an advantage to brushing first or flossing first. The research concentrated on the reduction of plaque bacteria, the cause of gum disease and tooth decay, as well as fluoride retention on the tooth surfaces after either brushing first or flossing first. 

What they found was that flossing before you brush resulted in a statistically significant  reduction of plaque bacteria between teeth when compared to flossing after brushing.  So, that meant that flossing first did a better job of cleaning teeth in the research. In addition, flossing first also resulted in a statically significant increase in the amount of fluoride retained on the surfaces between teeth when compared to flossing after brushing. So, again, it is better to floss first because the teeth are left with more fluoride on them to help fight decay.  Here is a link to a summary of the article  https://www.perio.org/consumer/brush-or-floss-first

So now we have an answer based on science. 

It is better to floss BEFORE you brush your teeth.

Toothbrush | from unsplashIt’s a pretty common question we get. It makes sense that a hard bristled brush would do a better job scrubbing your teeth, right?  However, the recommendation is to always use a soft bristled brush. 

 

The bacterial plaque and food debris that we aim to remove is a thin gel that is lightly attached to your teeth.  It comes off relatively easily with soft bristles.  While the stiffer bristles would remove it as well, the stiffer bristles can be stiff enough to damage your teeth.  

 

As an example, if you scrub a spot on your floor every day, twice a day, with a wire brush, it will quickly wear away a hole in the floor. On the other hand, a soft brush is much less likely to wear the floor away. The same holds for teeth. Harder bristles will damage teeth over time. 

 

What about tartar or calculus?

 

While tartar and calculus are harder buildups that are stuck on teeth, even the firm bristle brushes won’t remove it.  This is why you need to get your teeth professionally cleaned with the sharp instruments that can chip these buildups off your teeth.  Give us a call if it is time to get them professionally cleaned.  Your teeth will thank you for it. 

Coming in for regular cleanings with one of our excellent dental hygienists will help keep your gums in great shape, but what you do at home matters as well. Brush twice daily and floss every evening. Our hygienists will be happy to show you good brushing and flossing technique.

Other steps you can take to prevent gum disease include:

  • Don't smoke or chew tobacco
  • Eat a healthy diet full of fresh fruits and vegetables
  • Use an antiseptic mouthwash. We'll be happy to recommend one.
  • If you have a health condition that can affect your dental health such as diabetes, heart disease, or cancer, please let us know so that we can take extra steps to help keep your gums healthy.

Smiles Makeover

Invisalign is a popular and amazing option to help straighten your teeth and improve the way you can bite.  It is popular because it moves teeth without using the unsightly brackets and wires of traditional braces.  We love Invisalign, and Invisalign can address quite a few orthodontic cases very impressively, but Invisalign may not be the best way to go in some instances. Sometimes conventional braces are needed.  Sometimes, more advanced Invisalign treatments are required.  As in any treatment option that may have multiple options, we will evaluate your problems and discuss the pros and cons of the various options. If it is an Invisalign case that we feel comfortable treating, we can move forward with your case in our office.  If Invisalign isn’t a good option, or if it is a more advanced Invisalign case, we will refer you to an orthodontist so you get the best treatment possible. 

 

A simple answer is....sometimes.  The truth is that every implant case is so different that the options are based on the patient’s needs as well as the existing conditions.  With individual implants to replace single teeth, the tooth root shape and the implant shape are relatively similar, so we have a better chance to have the option to place an implant the same day the tooth is removed. For multi rooted back teeth, it isn’t as easy, or even possible to do same day implant placement due to the different shapes of a cylinder implant versus a multi rooted tooth shape. Other variables like bone shape, infection, or other health issues also come into play with immediate implant placement. I always tell patients that we don’t want to rush to do things wrong.  It is always better to do it right the first time, and although immediate placement may be desired, it isn’t always a good idea.

 

There are a lot of tv ads about getting implants done as well as “teeth in a day.”  To learn more about this particular implant option, click HERE

There are various reasons we do crowns as well as various processes involved.  Most of the time, after a tooth is prepared and an impression taken, we can have the crown ready to cement in two weeks.  Crowns on implants will often require an additional week to make as implant components must be ordered by the lab and custom parts fabricated.  Those additional steps require more time at the lab. 

 

There are other times that the time frame may differ for various reasons.  Sometimes we like to keep a temporary crown on, or even the permanent crown, using temporary cement for an extended period. We will do this when we have concerns about the health of the nerve in the tooth and we want additional time to evaluate it.  If we need the lab to make a post for the tooth, this will also require additional time and appointments. Other times, we will send you to the lab so the lab technician can see you for custom shading and tinting so the best esthetic result can be obtained.  Timing of that appointment and availability of the patient and lab technician may delay the final finish date accordingly.

 

Like so many things, we want them done right, not just fast.  We understand that patients want things done right away, but we want them done right. We will always go the extra mile to make sure you get the result you want and deserve. 

We offer a range of cosmetic dentistry services such as veneers, porcelain crowns, bonding using tooth-colored composite, and even orthodontic treatments like Invisalign. All our of dentistry is done with an eye toward aesthetics. We know that it's important that your teeth are both healthy and attractive. If you'd like to find out which of our services can help you meet your goals, call our office to schedule your consultation.

When people have chipped or worn teeth, it can result in esthetic concerns as well as produce discomfort of the teeth or joints. While patients want things fixed quickly, our first challenge is to determine the cause of the problem.  We always want to know the cause because we want to prevent further breakdown of the teeth, as well as have long term success with any new restorations we may place.  Sometimes the fix can be as simple as a filling, a crown or a veneer,  while other times the optimal treatment may get more involved. We often see an underlying cause of tooth breakdown related to grinding or clenching teeth. When there is significant wear throughout, the restorative treatment to address this problem may involve a full rehabilitation of crowns on many, or even all teeth to re establish a normal alignment of the teeth.  Other times we see an underlying cause that is orthodontic in nature and we need to treat the patient with orthodontics such as braces or Invisalign prior to any restorations.  So, our “cosmetic” options will be determined by the problems we are presented with, and we will always show our patients X-rays, photos, and plaster models to explain our findings and recommendations prior to starting any treatment. If you have any concerns with chipping or wear, give us a call so we can see what options you may have to restore your optimal smile. 

When patients talk about “cosmetic dentistry” we are always interested to hear what people think that means.  To us, dentistry has evolved to the point that we feel most services could be considered “cosmetic” as we use tooth colored filling material for almost everything.  That said, many people consider cosmetic dentistry to include the use of porcelain crowns, porcelain veneers, bonded white fillings on front teeth, tooth whitening or bleaching, and white fillings on back teeth.  And yes, we routinely perform all of these procedures.  We also utilize Invisalign to help straighten your teeth,  and dental implant restorations to restore a single tooth, multiple teeth, or even all of your teeth.  In fact, we even feel the conventional dentures and removable partials we fabricate also fall into the cosmetic category as we not only use top labs and materials, but also take every extra step to ensure they look as realistic as possible.  So yes, we do perform all of these cosmetic dental services, and we will discuss them with you, as well as present options and risks of treatment before we start your treatment. Give us a call to set up a consultation so we can see what can be done.

It seems like a simple question, but there isn't always one simple answer.  In order to answer that question, we would want to see you in our office so we could evaluate your overall oral health because any treatment is doomed to fail if the gums are not healthy enough to support the treatments.  Once we evaluate your periodontal (gum) health, we will evaluate your tooth health and determine which treatments are necessary.  We always  have to consider both form and function.  In other words, we not only want it to look right (form) but we want it to function.  Sometimes we may recommend orthodontic treatment prior to any restorative treatments.  Other times, something as simple as bleaching teeth is all that is needed to make things look brighter. Most of the time, the needs fall somewhere in between.  The best way to get an answer is to give us a call so we can see what you need, what you want, and then come up with a list of options based on your mouth and your wishes.  Give us a call so we can come up with a treatment plan that will fit your needs. 

We make every effort to select the best materials for your restorative needs. There are many options available for crowning teeth.  While gold teeth are often considered an older, not so esthetic option, they are still one of the best materials that can be used in dentistry. 

 

That said, most patients prefer the white crowns that look like real teeth.  The traditional Porcelain Fused to Metal (PFM) crowns have been widely used with great success in dentistry.  These PFM crowns can be made to look very realistic in most cases, but they are what we call “feldspathic porcelain” and this material’s biggest drawback is its low fracture toughness,  essentially, it can crack and chip easily. It also requires quite a bit of tooth to be cut away in order to use as directed. 

 

Lithium disilicate crowns are a newer option that is also highly esthetic.  This material has no metal substructure to hide and it also has a much higher fracture toughness than the PFM crowns.  This material also requires aggressive tooth prepping to use properly.

 

Zirconia is a newer material that is our strongest yet.  It is extremely strong and ther is no metal to hide.  Another benefit is the conservative tooth preparation that can be done to use this material.  The downside is that it is not as pretty of a material.  I looks good, but not great.  The manufacturers have developed even newer versions of this material that are starting to look much more like the other materials as far as esthetics, but the strength drops greatly with these options; however it is still much stronger than the traditional PFM crowns.

 

We choose the material we use based on needs.  Location plays a big role as back teeth do more work and would benefit from more strength, while front teeth don’t do as much of a chewing load, but are required to look good.  As fear as strength goes, the flexural strength (force to break the material) of a PFM is 90 MPa (MegaPascals), lithium disilicate is 400 MPa, and the strongest. Zirconia is 1465 MPa. You don’t have to understand the physics behind flexural strength or megapascals, but it is easy to understand that 1465 is more than 90. Since MPa is a unit of force needed to break the material,  zirconia is exponentially stronger for back teeth and is often used as we like the braun over the beauty. Lithium disilicate or PFM crowns are used more in front for beauty.  We also use labs that can custom tint crowns to get your shade as exact as possible.  We will make sure you are happy with the result you get.

Teeth Whitening

We offer a range of cosmetic dentistry services such as veneers, porcelain crowns, bonding using tooth-colored composite, and even orthodontic treatments like Invisalign. All our of dentistry is done with an eye toward aesthetics. We know that it's important that your teeth are both healthy and attractive. If you'd like to find out which of our services can help you meet your goals, call our office to schedule your consultation.

When patients talk about “cosmetic dentistry” we are always interested to hear what people think that means.  To us, dentistry has evolved to the point that we feel most services could be considered “cosmetic” as we use tooth colored filling material for almost everything.  That said, many people consider cosmetic dentistry to include the use of porcelain crowns, porcelain veneers, bonded white fillings on front teeth, tooth whitening or bleaching, and white fillings on back teeth.  And yes, we routinely perform all of these procedures.  We also utilize Invisalign to help straighten your teeth,  and dental implant restorations to restore a single tooth, multiple teeth, or even all of your teeth.  In fact, we even feel the conventional dentures and removable partials we fabricate also fall into the cosmetic category as we not only use top labs and materials, but also take every extra step to ensure they look as realistic as possible.  So yes, we do perform all of these cosmetic dental services, and we will discuss them with you, as well as present options and risks of treatment before we start your treatment. Give us a call to set up a consultation so we can see what can be done.

It seems like a simple question, but there isn't always one simple answer.  In order to answer that question, we would want to see you in our office so we could evaluate your overall oral health because any treatment is doomed to fail if the gums are not healthy enough to support the treatments.  Once we evaluate your periodontal (gum) health, we will evaluate your tooth health and determine which treatments are necessary.  We always  have to consider both form and function.  In other words, we not only want it to look right (form) but we want it to function.  Sometimes we may recommend orthodontic treatment prior to any restorative treatments.  Other times, something as simple as bleaching teeth is all that is needed to make things look brighter. Most of the time, the needs fall somewhere in between.  The best way to get an answer is to give us a call so we can see what you need, what you want, and then come up with a list of options based on your mouth and your wishes.  Give us a call so we can come up with a treatment plan that will fit your needs. 

It shouldn't. 

Most professional whitening products contain an added desensitizing ingredient that protects even sensitive teeth and keeps you comfortable during the process. Additionally, the customizable nature of professional whitening treatments prevents the product from coming into contact with soft tissues like your gums, lips, and tongue. 

If your teeth are very sensitive, please talk to us so that we can help you determine whether whitening is appropriate for you.

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