What we Offer
Patient Education
Our office has a warm comfortable theme in each room, as shown in the pictures below. Everyone knows that going to the dentist's office is not always the most pleasant experience. We have made the atmosphere as relaxing and inviting as possible, while maintaining the highest level of services available. In addition to the warm, caring experience of the staff,
each room is equipped with up-to-date equipment to ensure that you will only receive the best care when you come into our office. We offer digital x-ray technology, one visit crowns with CAD-CAM technology, and we also offer CAESY patient education program. CAESY is used as a computerized educational tool for our patients to help make them aware of what is available and educate them if they should have any questions about the procedures they are having done for themselves. This service is available to all of our patients, even while they wait for their appointment, because it can answer many questions you may have, and is of utmost importance to us that you are educated and aware of the treatment that is available.
Veneers
Our office has been providing porcelain veneers to our patients as an ideal choice for improving your smile, and because of the simplicity they provide. Procelain veneers are thin porcelain coverings for the front portion of the teeth that are bonded to the enamel. They can be made of different materials, composite veneers are done because of their durability, esthetics and affordability. Porcelain veneers are done because of their durability and realistic appearance. Veneers are a more conservative alternative to crowns since they require less removal of the tooth's original surface. These can be done on teeth that have not been compromised by large restorations or root canal treatment. With veneers in place, patients can expect straighter teeth with proper spacing and the shade selection can be to the patients desire.
The Procedure for Veneers
During the initial visit, the patient and dentist discuss the procedures that need to be done for the patient. If the placement of veneers are the option that we recommend, we will discuss the types and the cost. Shade selection will be a mutual understanding between the patient and the dentist. If we opt for two visits, instead of the CAD-CAM, CEREC restoration, which is done in one visit, we will have a second visit and require temporaries for a couple of weeks. On your first visit, the dentist removes a very small layer of each tooth's outer enamel. A local anesthesic will be used for this procedure to ensure comfort for the patient, remembering that a pill can be administered for oral sedation, and this is always available to anyone who is apprehensive about dental work. We feel very strongly about this because we want the experience to be a good one from the first hello to the day we say, “Everything is done!“ For the two visit veneer, Dr. Miles makes a mold or impression of the teeth and then sends it to a dental lab where they create customized veneers for the teeth. The lab prepares the veneers in roughly ten to fourteen days. During this time, the teeth may have a slightly different appearance because of the removal of the outer layer of enamel. Some patients may need to have temporary restorations placed on their teeth, but this step is not always necessary. Once the veneers have returned from the lab, the patient makes a final dental visit. The dentist applies the veneer to the tooth using a bonding material. When exposed to the ultraviolet curing light, this bonding material dries and hardens, bonding the veneer permanently to the tooth.
Composite Fillings
Until recently, dentists filled and sealed cavities exclusively using a silver with mercury amalgam. Unfortunately, these fillings (or restorations) often weaken teeth due to the large amount of the original tooth that had to be removed. They were also non-aesthetic, which is unacceptable for our now very beauty conscious society. Modern dentistry has increasingly turned to composite fillings as a strong, safe and more natural looking alternative to the dark gray or black fillings of the past. Composite fillings utilize a soft white plastic substance that includes a bonding agent that allows the material to adhere to the dentin and enamel of the tooth structure, as long as there is enough tooth material remaining to bond the composite to the tooth structure. This final curing or hardening of the composite material is done with an ultraviolet curing light that permanently bonds the composite to the tooth. Our office only uses composite restorations for the filling material of conservative restorations, because the use of the silver or “amalgam” restorations according to Dr. Miles, is not the “up to date” option for our family of patients.
Pros and Cons of Composite Fillings
The major advantage of these fillings is that they come in a range of shades that closely match the color of an individual's tooth. Due to the increased strength and durability of modern composite material, they can now also be used in the back teeth. In the past the cost of these restorations were much more than the traditional amalgam (silver) restorations, but due to the advances in the field of composites, the costs are now comparable. Dental insurances typically, but not always, cover the cost of composite fillings up to the price of the silver/mercury fillings. Some insurance companies are not covering them at all and some are coming up to date in their coverage for these modern types of restorations. Hopefully, we are all more interested in taking proper care of our teeth and are not being dictated by what the insurance companies say they will and will not cover.
The Filling Procedures
Dr. Miles will begin by anesthetizing the area being worked on, following the placement of topical anesthetic. She will then begin to remove any old filling material if required and remove any existing decay that is present. Once the tooth has been prepared, she places the cleanser (etchant) on the tooth, adds the desensitizer to the surface and then the bond which allows the composite to adhere to the tooth. This process is typically performed in several layers, after which it is cured or hardened with the use of a curing light. Composite restorations (fillings) for the back teeth are referred to as restorations and are done in one visit in the office. If the tooth decay is too extensive and the restoration requires more support, the tooth may need a composite or porcelain inlay or onlay. We offer CAD-CAM restorations in our office, which allow our patiens to have only one visit for these crowns or inlays or onlays. This is done with the CEREC machine and the restoration is milled directly in our office.
Bridges
A bridge is a device used to fill the space where a tooth has fallen out or been removed. A typical bridge consists of a pontic (a filler tooth) that is attached to two surrounding abutements (crowns). Once complete, this bridge structure is bonded into the mouth. Without the use of a bridge, spaces in the mouth from missing teeth can cause multiple teeth to shift, lead to occlusion (biting) and/or jaw problems and can cause periodontal problems. Bridges safeguard the integrity of existing teeth and help maintain a healthy, vibrant smile. These are currently done in two visits with the off-site lab fabricating the final restoration. This can be done in all ceramic or with a metal substructure under the porcelain material.
The Process
Bridges require at least two trips to the dentist's office. During the initial visit, topical anesthetic is placed and the area that is being worked on will have a local anesthetic placed. Dr. Miles will prepare the surrounding teeth by cleaning any plaque or decay that remains and reducing them so that there is enough clearance for the crowns' thickness. Then a mold or impression of the teeth is made and this is sent off to a dental lab, where the customized impression is used to prepare the model for the bridge preparation. The customized mold takes about two weeks to return to the office. At the initial appointment time, the patient is fitted with a temporary bridge constructed of acrylic resin. This plastic material is very aesthetic, but not as strong as the final product. It is intended to be used for only a short amount of time. When the patient returns to the dental office, the dentist removes the temporary bridge, that is retained with temporary cement, and we will fit the permanent one. Any adjustments for the bridge for the proper bite, fit and color match will be done at this time; then the bridge will be permanently bonded into the mouth. The bridge or crown in checked completely by Dr. Miles, along with the dental assistant and the patient to insure quality before it is cemented permanently.
Composite Bonding
Composite bonding is a technique used to improve the appearance of your teeth. The term composite bonding, sometimes referred to as composite veneers, refers to any composite material, either a plastic or resin, which is bonded to an existing tooth. Bonding is ideal for fixing chipped or cracked teeth, hiding discoloration on the tooth's surface, or reducing the gaps between teeth. Whatever the specific intent, composite bonding creates more aesthetically pleasing teeth and a brighter smile. Most of the time with the composite bonding, there is very little need for removal of the original tooth surface. In this way, it is much more conservative than procelain veneers, but in some cases the tooth does need to be shaved down some.
The Advantages of Bonding
Composite bonding is a quick process, typically lasting less than an hour, if we are working on just a couple of teeth. Compared to veneers or crowns, it is a popular choice because it does not reduce the tooth's original structure, it only requires one visit, it is very pleasing aesthetically due to the improvement in materials, and it is less expensive than porcelain veneers. However, the longevity of these types of plastic restorations is much shorter than their porcelain counterparts. As is also true for the porcelain veneers, the composites come in many different shades that have the ability to match the color of the surrounding teeth shades. The shade can be chosen to match the natural color of the original tooth if that is what you desire or to match more closely all of the adjacent teeth. Many times whitening techniques can be used to enhance the color of the surrounding teeth before the bonding is done so that we can match the shade of the whitened teeth.
Dental Implants
For individuals who wish to replace missing teeth, dental implants may be an effective long-term solution. This can be for someone who has lost just one tooth, or someone who is tired of trying to use a removable partial or even a complete denture. In many instances, it can provide greater structural support and perhaps even last longer than either bridges or partials or complete dentures. The implant itself serves as the artificial root to which the new teeth are supported. The implants are typically constructed of titanium, a strong and safe material that effectively attaches to the bone of the jaw. The procedure to insert the dental implants typically involve three steps: first, the implant insertion stage, or root portion of the implant, is done at the specialists' office, secondly, the osseointegration (the period of healing for the jawbone) when the implant itself has anywhere from 4 to 12 weeks to adhere to the bone. This portion of the healing process is monitored by both the specialist and Dr. Miles. And finally, when the integration is complee, the final restoration, or the attachment of the abutement and the new crown or bridge is fitted to the implant. This step is exclusively done at our office. Any follow-up visits to the specialist alternating between the two offices, are very important.
