FREQUENTLY ASKED QUESTIONS

Below we’ve provided answers to common patient questions.

• General Questions
• Implants
• I.V. Conscious Sedation
• Root Canal Therapy
• Gum Disease
• Aesthetic Dentistry
• Fillings
• Dentures
• Emergencies

General Questions

Q: Can I pay using my insurance?

A: We accept most forms of insurance and as a courtesy will process your claim for you. The patient is responsible for payment of any portion not covered by insurance at the time of service.

Q: Do you call to remind me of my appointment?

A: We call with a reminder two days before your appointment.

Q: What if I need to cancel my appointment?

A: We request a cancellation notification 48 hours in advance. This way, we can offer your appointment to someone else who might be waiting.

Q: Do you accept credit cards?

A: Yes. We accept most types of credit cards, including MasterCard and VISA.

Q: Do you have payment plans?

A: Yes, for some procedures, the patient pays for part of the cost at one appointment and completes the payment at the next appointment. We also have a program called Care Credit which in which the patient gets acceptance verification within 20 minutes from an outside lending institution.

Q: What type of dentistry does this office offer?

A: We perform all phases of general dentistry, including fillings, teeth cleanings, root canals, extractions, and more, but the special focus of our office is on dental implants and aesthetic & reconstructive dentistry.

Implants

Q: What are dental implants?

A: Dental implants are small diameter “screw-like” devices which are placed into the bone. After the bone integrates (grows into) the implant, teeth or other fixtures may be attached to the implant body. Dental implants are the most successful method of replacing a missing tooth available today. Another important advantage with the dental implant is that no other teeth are touched in the procedure.

Q: Who places the dental implant into the bone?

A: Most implants can be placed in our office with the use of local anesthesia. Post operative pain is very minimal for most patients. In some more complex cases, or instances where the patient wants to be “put out” (i.e. conscious sedation or general anesthesia), we use oral surgeons or periodontists to place the implant. After healing, we restore the implant at our office.

Q: How long have implants been performed?

A: Implants have been placed for over 40 years.

Q: How successful are dental implants?

A: Success rates vary in different parts of the mouth. In the lower jaw, success rates measured 15 years after placement are generally over 90 percent. In the upper jaw, the rates are 80 percent, or higher, fifteen years after placement. Rates are very similar beyond 20 years.

Q: What happens when an implant “fails”?

A: In the very rare case (4-6 percent of the time) that the implant fails to integrate to the bone. Usually there is a zone of bone loss around the implant, which makes the implant loose and necessitates the removal of the implant. This area where the implant has been removed can often be grafted at the time of implant removal. After healing, another implant can be placed.

It is very important to determine if an implant is not integrating properly so it can be removed. This is why we strictly follow up on implants we’ve placed.

Q: Can anyone get an implant?

A: Most healthy individuals are good candidates for implants if they have adequate quantity and quality of bone. Some of the factors that decrease the success of implant therapy include but are not limited to: smokers, diabetics and patients taking biphosphonate medicines for osteoporosis.

Q: How long does it take to “get a tooth” when using implants?

A: The answer to this question varies from case to case. Sometimes patients get a tooth the day of the implant surgery. Sometimes it can take over a year to get the permanent tooth.

I.V. Conscious Sedation

Q: What is I.V. Conscious Sedation and who can benefit from it?

A: IV Sedation is used to deliver medications to a patient which make them very relaxed and create profound amnesia. The drugs make a long procedure seem short and for most patients the entire procedure is at best a vague blur - often there is no memory of the procedures performed. This all occurs while the patient is awake enough to follow verbal commands from the dental team. Compared with oral sedation, I.V. sedation allows for much more fine (and safe) control of the patient's sedation level. Sedation medications and their reversal agents act immediately when delivered via intraveneous line. Oral sedation drugs require absorbtion from the gastro-intestinal tract which is slow and unpredictable. We use the same drugs used by medical doctors to perform colonoscopies and many other outpatients services. I.V sedation may benefit you if you are an extremely anxious dental patient, need to get a lot of work done in one appointment, have a significant gag reflex or high salivary secretions or have medical conditions where the stress of dental treatment puts you at risk of a medical emergency. In addition, the intravenous line allows immediate delivery of profound anti-inflammatory drugs should your procedure require them.

Root Canal Therapy

Q: What is a root canal?

A: Root canal therapy refers to the removal, disinfection and sealing of the hollow space inside all teeth where the blood vessels and nerves reside.

Q: How do I know if I need a root canal?

A: Your dentist needs to make the ultimate diagnosis, but common signs include prolonged (over 30 seconds) pain to hot or cold, or unprovoked pain, which could be a dull ache, sharp piercing pain, throbbing and pain when chewing or touching the tooth. Facial swelling can also occur and can have a quite rapid onset and dramatic appearance. This is why early diagnosis and treatment is of the utmost importance.

Q: Are root canals as painful as some people say?

A: Usually root canal therapy is much more comfortable than in past years. Advances in treatment allow us to perform root canals more quickly, easily, comfortably, and better than ever before.

Q: How long does a root canal take?

A: Generally, root canals can be completed in one visit, lasting between one to two hours, depending on the difficulty of the root anatomy.

Q: Does your office perform all types of root canals?

A: No. We perform most root canals, but utilize the skills of our local root canal specialist for some teeth or circumstances.

Q: After the root canal is completed, is the tooth “done”?

A: No. Most teeth in the back portion of your mouth require a crown to protect the tooth from fracturing. Sometimes, teeth in the front area of your mouth, a simple filling can be placed over the access hole instead of a more expensive crown.

Q: Do root canals always solve the problem when a tooth hurts?

A: No. Root canal therapy is over 85 percent successful but sometimes, invisible fractures in the root of the teeth or unusual tooth anatomy prevent root canal therapy from being successful.

Q: What other options are available if my tooth needs a root canal and I don’t want one?

A: Extraction of the tooth is the most common treatment when a root canal is not desired by the patient. The other option is to do nothing, which is not advised by this office.

Gum Disease

Q: What is gum disease?

A: Gum disease describes two major categories. The first and more minor form is known as gingivitis, or the inflammation of the gums. This form is usually easily treated by having your teeth thoroughly cleaned and adopting good oral health habits as described by your dentist and hygienist. The second form is known as periodontitis, which is one of the leading causes of adult tooth loss. This disease is defined by the loss of the supporting structures of the teeth (i.e. the foundation) such as the fibrous attachments and bone. The disease is caused by the accumulation of destructive bacteria under the gums that cannot be treated by the patient, or even a dental cleaning. A variety of therapies are available but once a patient has periodontitis, it is very difficult to completely “heal” them, and frequent maintenance and diligence is necessary by all for the rest of the patient’s life.

Q: How do I know if I have periodontitis?

A: Bleeding gums, bad breath, loose teeth all may be signs that you have periodontitis but only a thorough exam can tell you for sure.

Q: Does gum disease hurt?

A: Not usually. By the time the patient feels pain from gum disease it is often at the later stages of the disease. This is why early diagnosis and treatment are essential.

Aesthetic Dentistry

Q: How does a person get a “knock-out smile”?

A: Modern techniques and materials allow us to create unprecedented beauty in a person’s smile. Treatment can range from simple whitening procedures to orthodontics along with a variety of aesthetic treatment options.

Q: I like the look of my teeth but not the shade (color), what can I do?

A: Bleaching may be the answer. Several types of bleaching are available. Over-the-counter bleaching strips can be effective, but only cover the area from canine to canine. At home, bleaching trays that can be made by our office are very effective for most patients. For those patients who want more instant results, in-office Zoom whitening can quickly lighten teeth.

Q: How will improving my smile affect my bite?

A: Before any aesthetic treatment is performed, a thorough analysis of your occlusion (bite) must be performed. In our office, we often create our finished smile design on mounted models to make sure that your bite is either maintained or improved at the same time that we improve the aesthetic appearance. We also often “mock-up” what we are trying to achieve on the patient’s actual teeth with tooth-colored filling material so they can see what improvements can be expected.

Q: My teeth are really worn, irregular and unsightly and it seems like they’re getting worse as I age. What can I do?

A: People usually don’t realize that they are clenching or grinding they’re teeth. More than likely, the destruction noted above resulted from years of unrecognized clenching and grinding which destroyed some of the protective design inherent in a healthy bite or possibly the person never had an ideal bite to begin with, which allowed an accelerated breakdown of this person’s dentition. A careful analysis of this person’s bite is recommended. The source of initial breakdown must be identified so the new restorations don’t suffer the same fate as the person’s original teeth. Even beautiful new smiles can be destroyed if they aren’t protected both by design, as well as other methods. Our office focuses on the treatment of this type of problem. Correctly diagnosed and treated, a person like this can have a long lasting gorgeous smile that they’ll appreciate every time they smile... which will be a lot!

Q: I want to improve my smile but I’m over 50 and don’t want teeth that jump out with their brightness. Can this be done?

A: Absolutely. We encourage patients to restore their smile in a way that appears as natural as possible. We try in the restorations prior to placing them permanently and only finalize the placement when the patient is totally pleased with the result.

Fillings

Q: What kind of materials are “fillings” made of these days?

A: The main materials are as follows: 1) gold 2) porcelain 3) composite 4) amalgam. I’ve listed the materials from best to worst based on function and longevity. Despite the yellow-gold color, gold has long been the standard to which all other dental restorations are compared. If yellow-gold restorations aren’t something you’re interested in, bonded porcelain or composite (tooth-colored resin fillings) can be an excellent choice. Amalgam has been with the dental profession for many years and has been a stellar performer in many ways. Amalgams are generally inexpensive and can last decades in some people’s mouths. Unfortunately, amalgams are well known for aiding in the fracture of teeth – which can create even more problems for the patient.

Q: I’m 33 years old and I’m confused about which filling I should choose, what should I do?

A: As stated above, the younger you are, the more important it is to do it “right”. The more a dentist cuts on your teeth, the more likely it is that you’ll develop more problems such as fractures and nerve death. Gold fillings can be done in an almost invisible way, which is why they are the premiere choice for you.

Dentures

Q: What’s wrong with dentures, I have lots of friends who have them and are pleased?

A: If the patient is pleased, there is not a lot to say other than they may not always be pleased in the future. When the jaw bone senses that no teeth are present, it slowly disappears (resorbs). As this happens, dentures fit increasingly poorly. This is one of the reasons many dentures are found in the trash at nursing homes—they stink! I personally don’t want to spend the last years of my life unable to enjoy foods and being in constant discomfort. This is why we recommend some sort of support for our patient’s dentures.

Q: What does “support” mean?

A: It means the denture has something to stabilize it other than just resting on the gums. Support could come from the patient’s own teeth, such as in a partial denture, or even under a full denture. If the patient doesn’t have any teeth left, implants create amazing support as well as security. Patients who have implants to support their dentures are amazed at how their dentures snap in and don’t dislodge, no matter what they eat.

Emergencies

Q: My tooth just aches. Even when I don’t do anything like eating it just has a dull ache...what’s wrong?

A: More than likely, you have a tooth that is dying. Confirmation and identification of the offending tooth is necessary by your dentist.

Q: My tooth feels pretty good most of the time – except when I bite on it I get a sharp, lancing pain. It may or may not happen every time I bite on it. Sometimes it seems like I just hit it a certain way with certain foods and I get that nasty “Zing”... what’s up?

A: More than likely, you have a fractured tooth. Sometimes a crown can hold a tooth together and eliminate the problem. Other times, a root canal or even extraction is needed.

Q: My tooth hurt all by itself, like you’ve described, and then went away... do you think I’ll be alright?

A: Hard to say. There’s a very good chance that you have a tooth that is dying. I would recommend having your tooth checked out. Dentists and endodontists can perform a vitality test, which can help determine if your tooth is healthy or not.