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BONDING

Bonding is a conservative way to repair slightly-chipped, discolored or crooked teeth, often for cosmetic purposes. The process comprises placing a white filling on your tooth to improve its appearance. The filling "bonds" with your teeth, and because it comes in a variety of tooth-colored shades, it closely matches the appearance of your natural teeth.

Bonding can also be used in place of regular amalgam fillings. Many patients prefer bonded fillings, because the white color is much less noticeable than the silver of the amalgam fillings. Bonding fillings can be used on front and back teeth, depending on the location and extent of tooth decay.

Bonding is less expensive than other cosmetic treatments and can usually be completed in one visit to our office. However, bonding can stain and breaks more easily than other cosmetic treatments like porcelain veneers.

If your bonding does break or chip, please let us know. We can generally patch or repair bonding in one visit.

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HEADACHES

The causes of symptoms such as Headaches, Sinus Headaches, Tension Headaches, Migraines, pain in face or behind the eyes, etc…are varied depending on the philosophy of the health professional that you talk to. Many physicians will attribute this potentially debilitating disease to problems in your arteries, veins, or your nervous system. The psychiatrist often attributes this to emotions or stress. Dentists will look at the structural balances of the overall system.

When working on any patient, there are three different basic aspects to Health. We deal with the Biomechanical aspects, the Biochemical aspects, and the Emotional aspects. Each of these aspects can be the primary problem, as well as being the primary complaint or symptom.  Remember that the symptom is rarely the primary problem! And that the symptom is often far removed from the underlying cause! Of these three aspects, Dr. Pucel feels that the Biomechanical or "Structural" component is the most important. If we have a good structural base from which to function, the other systems do not need to compensate for the faulty mechanics.

The primary structural imbalance that causes these symptoms could be located in your bite or in your body. If the primary imbalance is in the body, Dr. Pucel has "cured" many of his patient's headaches by referring them to a Physical Therapist, Chiropractor or Osteopath.

But, just as often the primary imbalance is located in the bite. Few patients realize that their bite could be driving the imbalance. In fact, most believe that their teeth fit together just fine, but their "normal" bite is actually an accommodated position that may or may not be healthy for them. In which case the bite must be rebalanced to a more balance position.

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PERIO PROTECT

When bacteria sits in your mouth, it starts to form communities or colonies, called biofilm, growing in the spaces or pockets between teeth and gum tissue. This is when the bacteria becomes more destructive causing the high percentage of gum/periodontal disease that we see in so many of our adult patients.

The Perio Protect®  system is a comprehensive method that is customized for individual patients to help manage these biofilms. With the Perio Protect Method, you can place prescribed solutions into periodontal pockets with an appropriately formed, customized dental tray between office visits to help manage biofilm. Although a dentist must choose the most appropriate solution for individual patients, the most commonly prescribed solution with the Method has oxidizing and oxygenating agents.

Dr. Pucel and Dr. Row have both seen miraculous healing of the mouth of patients that use the Perio Protect Method in conjunction with other treatment modalities. In fact, Dr. Pucel tells his patients, "If you wear it as prescribed, you will heal." For most people following the Perio Protect Method, the placement of prescribed solutions into a periodontal pocket via a customized prescription tray requires only minutes each day.  Patients describe the tray delivery as comfortable and appreciate its non-invasive technology.

Click here for more information.

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BRIDGES

A bridge is an ideal method to fill the space created by missing teeth. A bridge is one or more artificial teeth that are cemented into place using the real teeth on either side for support--hence the name. Bridges are a perfect option for filling the space created by a missing tooth. A bridge replaces the missing tooth both functionally and cosmetically. Bridge work is as much an art as it is an exact science. Bridge materials include gold alloys, porcelain bonded to metal alloy, or all-ceramic material made to match your natural tooth color. The choice of material depends on requirements for strength, wear, and/or esthetics.

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CROWNS

Crowns are used to restore and enhance teeth that are damaged, or to replace missing teeth. A crown, also called a cap, is used to entirely cover a damaged tooth. A crown not only strengthens the tooth, but it can also dramatically improve the tooth's appearance, shape and alignment.

Crowns may be used to...

• Replace a large filling when there is little tooth structure remaining
• Protect a weak tooth from fracturing
• Restore a fractured tooth
• Attach a bridge
• Cover a dental implant
• Cover a discolored or poorly-shaped tooth
• Cover a tooth that has had root canal treatment

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DENTAL CLEANING

Cleanings should be performed every six months to prevent excessive plaque buildup in healthy mouths. More frequent cleaning may be required if there is any gum disease. Plaque left untreated can lead to unhealthy gums and tooth decay. A routine dental cleaning should include scaling, root planing and polishing.

Scaling and root planing is performed to treat periodontal disease. It is the process of removing plaque and tartar from all root tooth surfaces with a variety of methods, depending on the amount of plaque and tartar, usually while the patient’s mouth is numb. Dental hygienists traditionally perform scaling by hand. However, new and advanced technology has led to more modern methods such as electric ultrasonic scalers. This sophisticated tool allows dental cleanings to be performed more efficiently and in less time. Both electric ultrasonic and manual scaling methods can be combined to achieve the best results.

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DENTURES

A denture is a removable replacement for missing teeth and surrounding tissues. There are two types of dentures available: partial dentures and complete dentures. Partial dentures are used when some natural teeth remain and complete dentures are used to replace all teeth. Dentures are made to resemble your natural teeth, so there should be no noticeable change to appearance. In fact, dentures may even improve a smile!

Complete Dentures – This restoration method is used to restore smile and mouth function if all teeth have been lost. The dentures are custom created and natural looking. They are fit in the patient's mouth to take the place of the original teeth. Complete dentures are generally removable and may require adjustments in order to create a proper fit with the gums and mouth.

Partial Dentures – A removable partial denture is used when one or more natural teeth still remain in the upper or lower jaw. Made of replacement teeth attached to a pink or gum-colored plastic base, partials help restore better functionality to the mouth. As with complete dentures, it is possible to have more permanent option cemented into place.

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EXTRACTIONS

Good oral hygiene is a must. The loss of a single tooth can have major impact on overall oral health and appearance. Although dentists will use every measure to prevent tooth loss, there are still some occasions when a tooth needs to be extracted. A tooth may need to be extracted if the following occurs:

• Severe decay
• Advanced gum disease
• Infection or abscess
• Orthodontic correction
• Malpositioned teeth
• Fractured teeth or roots
• Impacted teeth

The dentist may suggest an extraction after careful examination and treatment—usually taking x-rays to understand the shape and position of the tooth and surrounding bone before extracting the tooth. Based on the degree of difficulty, a dentist may refer you to an oral surgeon.

A certain amount of discomfort is to be expected following an extraction, but it can be minimized with pain killers and ice packs applied to the face for 15 minutes at a time. Discomfort should lessen within three days to two weeks.

If you experience prolonged or severe pain, swelling, bleeding or fever, call our office immediately.

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FILLINGS

A filling is a way to restore a tooth decayed tooth back to its normal shape and function. If you have a tooth that requires a filling, the dentist will first remove the decayed tooth material, then clean the affected area and fill the cleaned-out cavity with a filling material. This filling will help prevent further decay by closing off any cracks or spaces where bacteria might enter.

There are a variety of filling materials available including gold, silver, plastic and porcelain. We will work with you to determine which material is best for you, depending on the extent of repair, the location of the filling and the cost. Each of the filling materials is briefly explained below:

Gold fillings are custom-made in a laboratory and then cemented into place. While gold fillings are often the most expensive choice, many consider gold as the best filling material. Gold inlays are well-tolerated by gum tissues and may last more than 20 years.

Composite (plastic) resin fillings are custom-made to the exact color of the patient's teeth, creating a more natural appearance. While these white fillings may be less noticeable than other materials, they usually only last between 3 and 10 years. They may not be ideal for larger fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco.

Porcelain fillings, called inlays or onlays, are created in a lab and then bonded to the tooth. They can be matched to the color of the tooth, they resist staining, and they cost about the same as gold fillings. A porcelain restoration generally covers most of the tooth, making the filling nearly undetectable.

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PERIO/GUM TREATMENT

It's estimated that more than half of U.S. adults have gingivitis (gum disease). Gingivitis, in some cases, can lead to periodontitis (gum disease with loss of supporting bone around the teeth) and host of other health problems.

Gum disease is caused by a buildup of bacteria in deep pockets between the teeth and gums. The body’s response to this oral bacteria increases inflammation throughout the body.  It is this inflammation which pervades the body and puts you at a much higher risk to develop the following health problems:

• Stroke
• Respiratory Disease
• Heart Disease
• Diabetes
• Ulcers
• Osteoporosis
• Arthritis
• Pre-Term Births

The dentist may also suggest specific toothpastes, mouth rinses, and Perio Protect therapy. We may also prescribe antibiotics to fight infections. Surgery is required for the most severe cases.

While it is normal to evaluate your gum health at your check-up and cleaning appointment, patients with active periodontal disease will need to be monitored more frequently than the normal twice per year check-up. If you have been experiencing any symptoms like bad breath, bleeding or tender gums, please let us know. We will decide what is the best form of treatment to restore your gums to optimum health.

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IMPLANT PLACEMENT

A dental implant is an ideal tooth restoration for people who are missing one or more teeth for reasons like injury or periodontal disease. To begin the implant process, a metal post is surgically positioned into the jaw. This post will act as a permanent "root" for the implanted tooth. Once it is in place, the surrounding bone and tissue needs time to heal.

Implant placement requires special training, as it is a surgical procedure. Our team is highly- trained in implant placement to meet your dental needs. Implants require healthy gums and adequate bone. A patient must also be committed to excellent oral hygiene and regular dental visits, as these are critical to the long-term success of dental implants.

Please set up a consultation for this comprehensive procedure.

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IMPLANT RESTORATION

A dental implant is an ideal tooth restoration for people who are missing one or more teeth for reasons like injury or periodontal disease. After an implant is placed, the restoration is completed with a replacement crown. While implants are typically more expensive than other methods of tooth replacement, they provide superior benefits. Implants are stronger than natural teeth and generally last 10-20 years. They are also a more favorable approach than bridgework, because they do not depend on neighboring teeth for support.

Implants require healthy gums and adequate bone. A patient must also be committed to excellent oral hygiene and regular dental visits, as these are critical to the long-term success of dental implants.

Please let us know if you have any questions about the procedures involved in dental implants.

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INVISALIGN

Invisalign is an attractive alternative to traditional metal braces. It is a series of clear, custom-fit removable mouth trays that apply a controlled amount of force to your teeth to slowly straighten them. The system provides the same beautiful results as traditional braces, but they are virtually invisible. Because Invisalign trays are removable, they can be taken out while eating, drinking, brushing and flossing.

The Invisalign system begins in the dentist or orthodontist's office with taking molds of the teeth to design your trays. Patients switch trays every two weeks to gradually shift the teeth. The system requires a visit to the office every six weeks so that treatment can be monitored. Once treatment is complete, a patient will likely be given a retainer to maintain the smile.

The cost of Invisalign varies according to the complexity of the case. Insurance policies generally cover Invisalign to the same extent that they cover traditional braces.

Contact us for an Invisalign consultation.

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IV SEDATION

A variety of forms of dental sedation are used to help patients who suffer from dental anxiety or phobia. There are multiple levels of sedation to ease every level of anxiety, and IV sedation is the perfect option for patients who might otherwise avoid the dentist. IV sedation is commonly referred to as "sleep dentistry--" it will be as if you fell asleep, and you won't remember the procedure. A specific set of drugs are administered via IV for the duration of the procedure or procedures, and you will be carefully monitored to ensure your safety. Often reserved for oral surgery, IV sedation is also available to those with intense dental anxiety and phobia. It makes dentistry easy.

If you feel that IV sedation is the best option for you, set up a consultation today! We are happy to answer any of your questions.

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MOUTH GUARDS

Custom-designed mouth guards and night guards are made of flexible plastic and molded to fit the shape of your teeth. Mouth guards are recommended to protect the jaw, tongue, cheek lining and teeth during physical activity and sports such as boxing, football, basketball, or other activities where your mouth might get hit. Night guards are recommended for patients who clench or grind their teeth at night to protect their teeth. Guards generally last 3-10 years.

Custom-made oral appliances can also be used as part of treatment for conditions like sleep apnea and TMJ disorders. In general, plastic appliances can be used to correct a variety of problems.

If you are active in athletics or experiencing any concerning experiences with your mouth, teeth, or jaw, please let us know. If any kind of guard or appliance is a good option for you, we will take an impression of your teeth to create a custom-fit product for your specific needs.

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NITROUS OXIDE SEDATION

Nitrous oxide sedation, also known as "laughing gas," is commonly used to make treatment more comfortable. The nitrous oxide is inhaled through a mask and produces a state of relaxation. Local anesthetic will be administered in conjunction with nitrous oxide to eliminate pain. Nitrous oxide is designed to make procedures easier for nervous patients and has been effective for many years.

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ORAL SEDATION

Oral sedation is an excellent option for patients who suffer from dental anxiety. It is simply taken in pill or liquid form and ingested at a set time before treatment. The drug produces a calming effect to make the visit to our office a much less stressful experience. Oral sedation is simple, safe and has very few side effects.

Ask us about our sedation options.

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ORTHODONTICS

Orthodontics is the art of using special appliances to straighten and align the teeth and bite. Braces are the most common orthodontic treatment. In this method, arch wires are threaded through brackets that are bonded to the surface of the teeth. The arch wires act as a track, and guide each tooth to its proper position. There are several types of orthodontic braces available, including the more traditional metal braces and ceramic "tooth colored" braces.

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ROOT CANALS

Root canal treatment, also referred to as root canal therapy or endodontic therapy, is used to save an infected or damaged tooth and avoid having to remove it. A root canal becomes necessary when a neglected cavity reaches all the way to the pulp at the center of the tooth, causing the pulp to become infected. Regular cleanings and checkups detect and prevent problems early on.

Trauma can also cause deep damage to the nerve of a tooth. Once this occurs, the pulp becomes infected, and it begins to eat away at the surrounding bone (this is called an abscess). By the time the pulp is infected it must be treated, and cannot heal on its own. It can even weaken the entire immune system, making it very dangerous and painful.

Symptoms of infected pulp may include sensitivity to hot/cold or sweets, pain, swelling, pain with biting or pressure, and a bad taste in the mouth. Sometimes, however, there are no symptoms, and you are unaware of any problem until a checkup.

A root canal is performed to clean out the infected tooth pulp and disinfect the canals of the tooth. The only other treatment would be to extract the tooth. Once the infection is resolved, the canal(s) is filled to prevent any further infection. Crowns are usually recommended to cover and restore a tooth after root canal therapy.

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SEALANTS

Sealants are a common preventive treatment in dentistry. Some teeth have fine grooves or pits that accumulate plaque, not because the person doesn't brush, but because the grooves are too narrow to allow even one bristle into them. When plaque accumulates, it can lead to cavities and other types of tooth decay. To apply sealants, a plastic material is brushed onto the tooth, filling these narrow grooves and preventing the cavity-causing buildup. Sealants make healthy teeth possible.

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SLEEP APNEA TREATMENT

Problems with sleep can quickly and negatively impact overall well-being. High blood pressure, heart disease, stroke, brain damage, depression, erectile dysfunction, diabetes, weight gain and more—all of these can be caused by sleep apnea and snoring. Solve your sleeping struggles at the dentist's office? It's definitely possible.

Oral sleep appliance therapy can be a very effective treatment option for patients suffering from mild to moderate obstructive sleep apnea. These custom-fit appliances shift the lower jaw forward and open the bite and airway.

Following are some common symptoms of sleep breathing disorders:

• Daytime drowsiness or fatigue
• Loud, recurring snoring
• Choking or gasping for air in your sleep
• A man with neck size greater than 17 inches
• A woman with neck size greater than 16 inches
• Stop breathing while asleep
• Unexplained weight gain/trouble losing weight
• High blood pressure
• Acid reflux
• History of stroke or heart attack
• Fall asleep during the day when activity is low
• Family history of sleep apnea
• Impotence

If you suffer from any of these symptoms, come into our office for a consultation. We will review the severity of your condition and discuss dental sleep treatment. It is always best to have had a sleep study conducted to determine the severity of your problem. However, this may not be necessary in treatment for simple snoring.

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TMJ TREATMENT

TMJ stands for temporomandibular joint and is used to describe dysfunction or disorders related to the joint. "Temporo," refers to the temple area of the skull; "mandibular," refers to the lower jaw; and "joint" is essentially where the head and jaw meet. Problems in this joint may be caused by a trauma, misalignment of the teeth, or excess muscle tension. The two bones that meet at the jaw are buffered by cartilage and five different muscles, so TMJ can cause a variety of troubles.

Common TMJ symptoms:

• Headaches
• Earaches
• Trouble/soreness in opening and closing the mouth
• Clicking or popping of the jaw
• Pain in the jaw muscles
• Soreness in the area, sometimes extending to the face

Dental treatments for the condition can include replacing missing teeth, moving teeth, adjusting the bite, filling gaps between teeth, and more. There is no one solution that is right for all cases. Sometimes a plastic mouthpiece is used to prevent clenching or grinding that is contributing to the problem. If TMJ is left untreated and reaches extremes, surgery may be required to repair the badly damaged joint.

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VENEERS

Veneers are a cosmetic dental procedure in which a thin layer of porcelain or composite material is placed over the outside of the tooth. They are used to improve esthetics or help with tooth damage. Veneers are usually only performed on the front part of the teeth that are visible when talking or smiling. The procedure can be direct or indirect.

The direct technique usually involves placing composite resin on the outside of the tooth using bonding. Because of that, the direct technique is usually referred to as bonding.

The indirect technique usually involves two appointments because the veneers are fabricated at a dental laboratory. At the first appointment the teeth are prepared, impressions are taken, and the teeth are given a temporary covering. The veneers are back from the laboratory after two or three weeks. The temporaries are removed, and the veneers are bonded to the teeth. The laboratory-fabricated veneers are usually made using porcelain or pressed ceramic, and are esthetically pleasing.

The advantage of veneers versus crowns is that much less of the tooth material has to be removed, and the procedure is generally less uncomfortable. Veneers are not recommended for patients who have large fillings or little tooth structure. They are also typically recommended for the restoration of front teeth.

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TEETH WHITENING

Teeth whitening is a popular procedure to make your teeth whiter and brighter, and therefore more attractive. Bleaching can be used to whiten stained and discolored teeth, or simply to enhance a dull smile. Either way, teeth whitening is a safe and relatively painless procedure for most patients. Whitening comes in strips or trays. We offer a wide variety of options for you at our practice.

Tray whitening is a less-expensive and convenient at-home whitening treatment. The results are more gradual. An impression is taken at the dentist's office in order to create a customized clear tray. Trays are generally ready within a few days, depending, and the patient must follow instructions for how to apply the gel in the trays and how often to use it. Maximum whitening results and a dazzling smile are achieved at the end of the set treatment period. An occasional treatment can be used to maintain the new smile.

Whitening strips can be available at the local store or at dental practices. The dentist will have the best recommendations for your needs.

Ask about our whitening options! Please consult us about use of over-the-counter whitening treatments.

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WISDOM TOOTH EXTRACTIONS

Wisdom teeth are the last molars, or "third molars" that develop on each side of the jaw. They usually emerge in the back of the mouth between the ages of 16-20.

Wisdom teeth are a valuable asset to the mouth when they are healthy and properly positioned. Often, however, they cause problems and require removal. When the jaw isn't large enough to accommodate wisdom teeth, they can become impacted. Impacted wisdom teeth may grow sideways, emerge only part way through the gum or remain trapped beneath the gum and bone.

A wisdom tooth extraction is a relatively routine procedure. The dentist will numb the area in the mouth with a local anesthesia or use IV sedation so that the patient is asleep during the procedure.

After the tooth (or teeth) is removed, the patient is given gauze and bites down softly for a recommended amount of time to limit any bleeding. Some pain and swelling may occur, but it will usually go away after a few days. Please call our office if, after following post-op instructions, you have prolonged or severe pain, swelling, bleeding or fever.

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FILM X-RAYS

X-rays are a focused beam of x-ray particles that pass through bone to produce an image on special film, clearly showing the structure through which it passed. This creates the familiar black-and-white images doctors and dentists use to diagnose oral health issues. Without an x-ray of the whole tooth and supporting bone and gum tissues, there would be no way to detect infection or pathology that requires attention.

X-rays are an integral part of diagnosis and approved for periodic use in comprehensive exams. If you have any questions or concerns, please let us know.

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DIGITAL X-RAYS

Digital radiography uses an estimated 40-90 percent less radiation than conventional film x-rays. Digital x-rays use a digital image capture device in place of traditional film, sending an image immediately to a computer. The result is a highly-detailed image of the mouth, and its contrast and resolution can be enhanced to more easily diagnose dental problems and determine the very best treatment for each case.

This means more safety and better accuracy for you.

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DIGITAL IMAGING

We use digital imaging software in our office, which allows us to take a digital picture of you and use our imaging system to predict how a particular treatment or cosmetic procedure would change the appearance of your teeth. This software is beneficial for patients who are considering cosmetic procedures but are not sure if they're ready for dramatic changes. Digital imaging also allows us to document your dental case and procedures very well. We take digital images of your face, teeth and smile to provide us with a permanent dental record and to provide a visual documentation of treatment.

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CAD/CAM

Our office utilizes CAD/CAM technology. CAD/CAM stands for "computer-aided design" and "computer-aided manufacturing". This technology allows the dentist to use an intra-oral scanner inside your mouth to take a digital scan of a tooth that has been prepared to receive a crown. Using special software, the data from the scan is used to generate a design (CAD) for a custom crown. This program will also generate a custom blue print and guide lines to manufacture the new crown (CAM). This software, paired with a state-of-the-art milling machine, enables our office to create precise and custom crowns, inlays and onlays in one single dental visit.

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CEREC

Utilizing CEREC technology allows the patient to receive a full or partial “tooth colored” crown in one visit. The crown is custom designed by the doctor on the computer and it is fabricated as you wait. The crown is adjusted, polished and bonded on in that same appointment.

With a CEREC crown there is no second visit to cement the crown– no temporary necessary and no second shot.

Because the Cerec Crown is bonded to the tooth rather than cemented and because there is no temporarily cemented crown, more of the tooth can be preserved

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E-CLAIMS

Many offices utilize electronic claims processing. This means that rather than being sent through the mail, a dental claim is sent electronically to an insurance company with the click of a button. We can submit information more efficiently and with fewer errors. This benefits patients because the turn-around time on claims is faster, and fewer claims are returned or denied.

We are happy to submit your dental claims to your insurance company on your behalf. Please let us know if you have any questions about the e-claim process.

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INTRAORAL CAMERA

Intraoral cameras, cameras about the size of a pen, help dentists see the condition of teeth and gums more clearly. This advanced technology allows us to zoom in on small diseased areas, cracks, chips and worn metal fillings to provide a more detailed view. The full-color images are sent to a computer screen, making it easy to see and diagnose dental problems much earlier than with traditional dental technology. Patients are also able to watch the whole process because the images are displayed on screens in treatment rooms.

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DIAGNOdent

Providing the absolute best service to our patients is of the highest importance to our office. To aid in achieving this goal, we use a new high-tech device called the DIAGNOdent. This small tool is a portable laser that allows us to detect cavities on the chewing surface of the back teeth that would have otherwise gone undetected by previous methods. Diagnosing cavities in the back of the mouth using traditional methods is difficult; studies even show that 50% of cavities are left undetected in these areas. However, the new DIAGNOdent enables us to locate and treat these cavities, putting a stop to further decay. The laser is easy to use, harmless, and will alert us with an audible signal if it detects a cavity. It will even calculate the approximate size of the cavity so we can better plan treatment. By using this device, you can rest assured that cavities will be accurately detected and treated in their infancy.

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LASER DENTISTRY

A laser produces a very narrow, intense beam of light energy. This light energy produced by the laser can remove or shape tissue. Laser procedures can be more precise. Also, lasers can reduce symptoms and healing times associated with traditional therapies; reduce the amount of bacteria in both diseased gum tissue and in tooth cavities; and control bleeding during surgery.

• reduce the discomfort of canker and cold sores.
• expose unerupted or partially erupted  teeth.
• remove muscle attachments that limit proper movement.
• manage gum tissue during impressions for crowns or other procedures.
• remove overgrown tissues caused by certain medications.
• perform biopsy procedures.
• remove inflamed gum tissues and aid in the treatment of gum disease.
• remove or reshape gum and bone tissues during crown lengthening procedures.
• help treat infections in root canals.