HOW SOON CAN I BE SEEN?

At The Center for Advanced Dental Care, we pride ourselves on remaining on time. We ask several questions on your initial phone call in order to determine immediacy. In cases of severe pain or an esthetic emergencies, we will see you right away. For routine new patient exams, we will arrange for an appointment ranging from, the day of the call, to no greater than two weeks, depending on your flexibility. We offer early morning, evening, Saturday, and lunchtime appointments to meet the busy schedules of our patients.

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HOW LONG DOES IT TAKE TO GET MY WHITE SMILE?

We offer two whitening systems: in-office and at-home. Our skilled assistants and hygienists are trained in the fabrication of whitening trays, which are needed for the at-home technique. From the time you decide that whitening is for you, and you are an appropriate candidate, we can have the impressions made and the trays fabricated in just a couple of days. The length of time necessary to achieve your final whitened state will range from 2-6 weeks.

The in-office technique is done at one sitting of 1½ hours. This appointment is a bit harder to schedule than the at-home because of the need for the 1½ hour of employee and chair time. However, if you are flexible, we can see you within one week.


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WHAT IF I AM AFRAID OF THE DENTIST?

It's easy to say that we treat everybody as if they had dental fear. However, dental fear is very complex, and although we are excellent and caring professionals, we are not mind readers. It's very important to inform us if you have fear, describe as specifically as possible what the fear is and if any relaxation techniques have worked for you in the past.


Your initial visit will not involve actual dental treatment. We will assess your dental needs, and recommend one of our proven relaxation techniques in order to complete your dental treatment, and more importantly, make you comfortable enough to schedule routine maintenance visits.

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WHAT IF I LOSE ALL MY TEETH?

The important question here is, why were they lost? If the reason is fear, we work with specialists who can utilize sedatum to place dental implants. If the reason is finances, we need to talk. Poor teeth or no teeth have been shown to have an enormously negative effect on general health, ability to eat a balanced diet, and self esteem which limits earning potential.

We will help you work through several options which will help your new beautiful smile become more affordable.

Many of our valuable assets are paid for on a monthly basis. A beautiful smile can be our greatest asset. Why not look into it today?

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WHAT SHOULD I KNOW ABOUT TOOTH SEALANTS?

Why seal teeth?
Over the past fifteen or more years, numerous materials and techniques have been developed to seal the top (occlusal) surfaces of teeth. These procedures are necessary because many teeth have defective occlusal surfaces when they completely erupt into the mouth, and food debris and microorganisms penetrate into the grooves on the teeth during eating. Patients cannot clean these areas effectively, and dental decay (caries) occurs frequently.

Do all teeth need to be sealed?
Usually, only the back (posterior) teeth require sealing. We cannot tell which teeth require sealing, as the incomplete fusion of the teeth often leaves a nearly microscopic entry from the enamel outside the tooth into the softer dentin inside. Therefore, we suggest that all posterior teeth and selected anterior teeth be sealed. A few teeth that do not require sealing may be sealed inadvertently, because it is impossible to select defective from nondefective teeth at an early age.

Will all decay be prevented?
Sealants prevent the majority of decay on the chewing surfaces of the teeth. However, routine fluoride therapy is required to decrease decay initiation on other surfaces of the teeth. Decay may begin between the teeth, even if sealants have been placed, if flossing and brushing are not adequate.

Cost?
The cost of sealing a tooth with plastic is less than one-half the cost of filling (restoring) the tooth in the event of decay. Further, the sealant does not require anesthetic, cutting, or weakening the tooth, while normal restorations require cutting and weakening of the tooth.

How long do sealants last?
Studies show sealants last many years. However, occasional resealing may be required, depending on diet and other factors.

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WHICH SHOULD I CHOOSE, SILVER (AMALGAM) OR WHITE (COMPOSITE)?

AMALGAM:

Advantages: Low cost, excellent contour, excellent contacts

Disadvantages: Crack teeth, not cosmetic, contains mercury

COMPOSITE:

Advantages: Excellent cosmetics, bonds tooth-prevents cracks, smooth surface

Disadvantages: Higher cost, erratic contacts, sensitivity 15% of the time


There is a push in the country to legislate against amalgam. The issue is related to mercury, which is toxic. However, there is absolutely no evidence in the literature of any health risk. The manner in which amalgam is placed precludes the negative effects of mercury.

We have been effectively using composites for several years, and in most cases, the results have been very good. For larger restorations, composites are not a good long-term solution because of the contour issues. As an alternative, we would recommend laboratory processed inlay-onlays when longevity is a factor. Although the cost is higher, the "cost per chew" is most likely lower. These restorations look great, last longer, and are more conservative than full crowns.

Insurance companies are usually 10 years behind in terms of reimbursement. For composites, they pay the same amount as for an amalgam, with the patient being responsible for the difference. The composite procedure is far more technique sensitive, so there is a learning curve. There is also an additional materials cost, which must be passed on to the patient.

My feeling is that one must consider the long term while contemplating which restoration to select. Although we restore one tooth at a time, each tooth is part of a larger community... how do you want your mouth to look, feel and function for years to come. Any added expense must then be figured into your long term decision. Consider whether the short term savings important enough to make a decision that will be in your mouth for many years.

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WHAT IF I GRIND MY TEETH?

Grinding is very common in both adults and children. Tension can manifest itself by tightening any muscles, including the jaw. However, there also may be dental causes for the grinding that may create complicated problems. These problems could result in tooth wear, migration, movement/mobility, muscle tenderness, temporal headaches, or tooth sensitivity. You should consult a dentist if you have any of these symptoms.

At our office, you will receive a comprehensive exam, consistent of a clinical exam, and molds of your teeth. The cause of the grinding will be determined and if appropriate, recommended corrective therapies will be discussed.

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WHY ARE PERIODONTAL ORAL EXAMS SO IMPORTANT?
(from June 2000 Newsletter)

Many patients wonder what we do during a periodic oral exam. We prepare for your visit by reviewing the dental and medical history the day before your visit. Any prior notes that relate to your hygiene visits are examined, so we can zero in on problems that have been noticed, but did not require treatment. We review recent x-rays to be sure that we are familiar with potentially troublesome areas, and if updates are necessary. We review the periodontal chart to be aware of areas, which have either been treated in the past, or are on the verge of needing conservative treatment. At the visit we perform a head and neck and intraoral career screening, cavity check, TMJ check, and gum check. This is done by both the dentist and the hygienist as two sets of eyes and hands are better than one. Both a short term evaluation and long term evaluation are made not only to prevent immediate problems, but also to create a longer term view to be sure that we are protecting your mouth for the future.

Naturally, all patients have different needs, so the nature of the periodic exams is different for each individual. Some visits are very brief, while others take a considerable amount of time. We hope we appear attentive to your needs and provide you with all the time you need to satisfy your concerns.

Also, as technology changes, there may be something available that was not previously in use.

We look forward to seeing you at your next cleaning and periodic exam.

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WHAT SHOULD I KNOW ABOUT FLUORIDE?
(from September 2000 Newsletter)

There are growing concerns about excessive fluoride intake. The ADA defines fluoride as a naturally occurring element that prevents tooth decay when obtained either topically or systemically. Topical fluoride which is contained in toothpaste, mouth rinses and professionally applied fluoride gels and rinses, adheres to the surface of the teeth. Topically applied fluoride provides local protection on the surface of the teeth, which in turn makes teeth stronger and more decay resistant. Systemic fluoride, such as dietary fluoride supplements in the forms of tablets, drops or lozenges or found in water, food, beverages, and the air, are ingested into the body and become incorporated into forming tooth structures. In contrast to topical fluoride, systemic fluoride ingested regularly during the time when teeth are developing are deposited throughout the entire surface and provide longer lasting protection.

The atmosphere contains small concentrations of airborne fluorides, however, studies conducted in the US have reported that very little is contributed to an individual's overall fluoride intake. Fresh water in the US has naturally occurring fluoride levels that can vary widely from less than .1 to over 13 parts per million (ppm). The Environmental Protection Agency requires the 102 public water systems they monitor to not exceed fluoride levels of 4 ppm. The optimal concentration for fluoride in water in the US has been established in the range of 0.7 to 1.2 ppm. This range will effectively reduce tooth decay, while minimizing the occurrence of mild dental fluorosis, the main adverse effect of excessive fluoride ingestion.

The ADA defines dental fluorosis as a change in the appearance of teeth and is caused when higher than optimal amounts of fluoride are ingested in early childhood while tooth enamel is forming. It is caused by a disruption in enamel formation which occurs during tooth development in early childhood and only becomes apparent when the teeth erupt. Dental fluorosis occurs while teeth are forming under the gums, therefore, after teeth have erupted and tooth enamel is completely formed, dental fluorosis cannot develop even if excessive fluoride is ingested.

One last point that is important to address is the lack of fluoride children may be receiving. Are you aware that bottled water, pre-made juices, and most filtered water may or may not contain fluoride? Parents should use more tap water for more optimal fluoride intake. This can be accomplished, for example, by cooking or making beverages with tap water instead of bottled water.

In conclusion, older children and adults are not at risk for dental fluorosis. For all practical purposes, the major concern should be the intake of fluoride by kids. Parents should closely monitor the amount of toothpaste a child is using at brushing times. The amount should never be bigger than the size of a pea. Children should be encouraged to rinse with water at least twice after brushing. The risk of dental fluorosis can be greatly reduced by closely monitoring the proper use of fluoride products by young children.

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