Services

Night Guards

Clenching and grinding teeth has been classified as a neuromuscular disorder. Overactive muscles can cause chipping, fractures, excessive wear and loosening of the teeth. Some studies report that stress to the head and neck system, causing muscle tension and pain in the jaw joints, may be related to chronic jaw clenching and grinding, also known as Bruxism. Studies show that 20 to 50 percent of people suffer from Bruxism.

How do I know if I need a Night Guard?

Your dentist or dental hygienist may ask or tell you that you grind your teeth at night. It’s easy for them to see the destructive effects of grinding on your teeth and gums. The pressure created by grinding can eventually wear your teeth down to nothing! Or, the person with whom you sleep may notice the sometimes loud and annoying sound nighttime teeth grinding can produce. Other warning signs that you may be grinding your teeth at night include headaches (sometimes severe) and jaw pain when you wake up in the morning.

The Procedure

The night guard takes 2 appointments. The first one is for the impression so a custom made Night Guard from the lab will be made precisely to fit to the patients teeth. The second appointment is to deliver the night guard and have an informative session with the patient on night guard care.

Bonding/White Fillings

A bonding is a composite resin that is used as an alternative to amalgams and veneers. This is an excellent cosmetic option for those patients who do not want the look of silver in their mouths and do not want the expense of veneers. Bondings can be used on teeth that are decayed, cracked, or stained.

Bonding Bonding

The Procedure

The bonding procedure is usually completed in one visit. The first step is to remove the decayed or unsightly portion of the tooth. The tooth is then etched with a liquid or gel and a bonding agent is then applied. This will allow the composite resin to be placed in the prepared tooth. The resin is then trimmed and polished, leaving you with a beautifully sculpted, natural-looking restoration.

Bonding Bonding

Bonding Durability

Although composite resins are cosmetically pleasing and easily placed, their durability is not as strong as other types of restorations. These resins typically last from 4-7 years before they begin to chip and wear away. When this happens, the restoration will need to be replaced.

Bridges

A bridge is one of the few options that you have when deciding how to deal with a missing tooth or teeth. The replacement of these missing teeth is necessary in order to maintain the proper mouth functions. Tooth loss can affect the way you eat, speak, and the alignment of other teeth in your mouth.

Types of Bridges

A bridge, by definition, is a link or connection between two permanent structures. A dental bridge is very similar in that it attaches the restorative teeth (bridge) to the natural teeth on either side of the gap. This bridge acts as your new teeth, closing the gap and restoring your smile. Bridges are often constructed of gold or metal foundations with porcelain fused to the foundation. This ensures that the bridge will support the normal functions of the mouth.

There are three main types of bridges:
-Traditional bridges involve creating a crown for the tooth or implant on either side of the missing tooth, with a pontic in between. Traditional bridges are the most common type of bridge and are made of either porcelain fused to metal or ceramics.
-Cantilever bridges are used when there are adjacent teeth on only one side of the missing tooth or teeth.
-Maryland bonded bridges (also called a resin-bonded bridge or a Maryland bridge) are made of porcelain teeth and gums supported by a metal framework. Metal wings on each side of the bridge are bonded to your existing teeth.

Bridge

Procedure

The procedure begins with preparation of the natural teeth, or abutments. We will shape the abutment teeth so that the ends of the bridge will fit comfortably on each one. The next step is to take an impression of the area. This impression will be sent to our lab where your new restoration will be crafted. While this new tooth is created, we will provide you with a temporary restoration. Our temporary restorations will resemble your natural teeth so that you can continue with your daily life without worrying about a missing or unattractive tooth.

Bridge Bridge

During your second visit to the office, we will proceed with the placement of your final restoration. This bridge will be fitted comfortably into the mouth. We will make every effort to ensure that the new bridge feels exactly like your natural teeth. The final step in the process is to cement the bridge into your mouth, leaving you with a beautifully restored smile.

Crowns

As we get a little older, our teeth begin to change and are prone to decay. There are many possible reasons for this change in your smile. These reasons can include bruxism(teeth grinding), general decay, cracked fillings, root canals, and many others. If your tooth is beyond repair with a filling material, we may recommend that the best viable option to save the tooth is a full crown. The reasons for this type of restoration in a badly damaged tooth are durability, cosmetic appearance, and overall support of the chewing function.

Types of Crowns

If we decide that you are in need of a full crown, there are a few different options for the repair of your tooth. These options include a full porcelain crown, a porcelain fused to metal or gold crown, or a full gold crown. We will make the determination as to which of these options is the most appropriate for your situation. You can be comfortable in knowing that your new tooth will be virtually unnoticeable and will flawlessly complement the rest of your smile.

Crown Crown

Procedure

When we have decided to go ahead with a full crown restoration, we will set aside 2 appointments for the entire process. Although the majority of crowns are completed in two visits, there is sometimes a need for a third visit to ensure a proper fit.

The procedure begins with the removal of all decay in the tooth. Once we have removed the decay, we will take an impression of the tooth. This impression will be sent to our lab where your new restoration will be crafted. While this new tooth is created, we will provide you with a temporary restoration. Our temporary restorations will resemble your natural teeth so that you can continue with your daily life without worrying about a missing or incompatible tooth.

During your second visit to the office, we will proceed with the placement of your final restoration. This crown will be fitted comfortably into the mouth. We will make every effort to ensure that the new tooth feels exactly like one of your natural teeth. The final step in the process is to cement the crown into your mouth, leaving you with a beautifully restored smile.

Dental Hygiene/Periodontal Health

In addition to the meticulous cleaning, polishing, and examination of your teeth, we also take the time to help our patients develop proper oral hygiene habits at home. We will evaluate your hygiene techniques and make adjustments to your routine where needed. Our doctor and hygienists will also make suggestions for preventative measures such as dental sealants or nightguards to protect against bruxism & TMJ.

If we feel that you are suffering from gingivitis or more severe gum disease, we may recommend a root scaling or planing. These measures can be instrumental in preventing bone loss and helping you to keep your natural teeth.

Dental Hygiene

Oral Cancer Screenings

During a dental exam, the doctor will check your neck and oral tissues for lumps, red or white patches or recurring sore areas.

Screening for early changes in the oral tissue can help detect cancer at a stage when it can be more successfully treated.

Smoking, especially combined with heavy alcohol consumption (30 drinks a week or more), is the primary risk factor for oral cancer. In fact, this combination is estimated to be the most likely trigger in about 75 percent of oral cancers diagnosed in this country. Other lifestyle and environmental factors also may increase your risk of developing oral cancer.

Scaling & Root Planning

Scaling and root planing is a non-surgical procedure in which the periodontist removes plaque and tartar from below the gum line. Root surfaces are cleaned and smoothed with specially designed instruments. It is important to remove the plaque and tartar from the pockets, because aside from the bacterial toxins that irritate the gums, plaque and the rough surfaces of tartar make it easier for bacteria to gain a foothold.

Whitening

Teeth looking a bit yellow or you need them to shine for that special occasion? We have a complete range of tooth whitening solutions so contact us today and ask us about the latest tooth whitening technologies to give you that brighter and whiter smile.

How does tooth whitening work?

Tooth whitening is the process of using a bleaching agent to lighten the shade of tooth enamel and eventually the dentin.

Bleaching takes 2 appointments. One is to make an custom impression. The second appointment is for the seat and instructions. Patients do bleaching 1 hour per evening for a period of 2 weeks for best results.

Common questions about Tooth Whitening

What can cause discoloring of my teeth?
The most common causes of tooth discoloration is smoking and coffee drinking although antibiotic stainning is frequently seen

I have crowns and veneers. Will they whiten as well?
Crowns and veneers are made of porcelain which is not affected by whitening agents

Why not just use over the counter tooth whitening products?
Over the counter products are recommended for keeping teeth white rather than getting the yellowness out initially.

Hydrogen Peroxide is common amongst whitening products. Does higher concentration mean whiter results?
No not necessarily. The end result is a combination of concentration of the active component in the gel, the period of time the gel is applied for and the incorporation of catalytic agents into the formula. Formulas vary between different brands of products.

Veneers

Porcelain veneers are extremely thin casings of ceramic that are bonded to the front of the patients’ tooth to create a new smile. Porcelain veneers are placed over the front of teeth that appear too small or large, slightly discolored, or simply are not cosmetically pleasing to the patient. For many patients, teeth may have chipped, become discolored, or are slightly crooked. For the majority of these patients, porcelain veneers can prove to be the perfect solution.

When placing porcelain veneers, we pay close attention to the patients surrounding teeth and design each veneer to complement the overall smile. The result is a beautiful, attractive new smile.

If cared for properly, your veneers will last you a long time. We ensure that your new veneers are constructed of the most durable porcelain materials available.

Veneer Veneer

Procedure

The procedure begins with the preparation of the tooth. This entails removing the discolored or unsightly portion of the tooth and meticulously shaping the tooth in preparation for the new veneer. Once we have shaped the tooth, we will take an impression. This impression will be sent to our lab where your new restoration will be crafted. While the new veneers are created, we will provide you with a temporary restoration. Our temporary restorations will resemble your natural teeth so that you can continue with your daily life without worrying about a missing or incompatible tooth.

Veneers Veneers

During your second visit to the office, we will proceed with the placement of your final restoration. The veneers will be fitted comfortably into the mouth. We will make every effort to ensure that the new tooth feels exactly like one of your natural teeth. The final step in the process will be to bond the new veneers into your mouth, leaving you with a beautifully restored smile.

Dental Implants

Dental implants are becoming more popular in today’s dental society for a number of reasons. Implants are utilized to offer patients a foundation for new restorative teeth where natural teeth are missing or have been extracted. The implant offers the patient the opportunity to regain normal function of the tooth without being forced to resort to a bridge or a denture.

Benefits

-The implant will osseointegrate (bond) with the existing bone.
-The new implant will support your teeth firmly and safely.
-Your new implants are aesthetically pleasing.
-You will no longer have pain during talking or eating.
-The dental implant will prevent progressive bone atrophy.
-Implants have a proven scientific basis.

Implants Implants

Procedure

The tooth structure has two main sections, the root and the crown. The root is the section of the tooth that is below the gumline. A dental implant acts as the restorative for this section of the tooth. The metal implant acts as an anchor in the jawbone. The first step of the procedure is surgical placement of the implant. Under regular dental anesthetic, the gum tissue is opened and the dentist places the implant into the jawbone. When this is achieved, the tissue is then sutured closed. There is not often significant discomfort with this procedure. This process can take from 1-3 hours depending on the number of implants being placed.

This implant will be left untreated for a period of 3-6 months. During this time, the bone will grow around the implant in a process called osseointegration. A removable crown may be utilized during this time period to allow for chewing and to preserve the cosmetic appearance.

Implant

The next step in the process is to attach an abutment to the tooth. This is achieved by exposing the top of the implant and placing the abutment. This is the part of the implant that will support the final crown.

Finally, an impression is taken of the implant and a final restoration is crafted. This restoration will be comfortable and cosmetically pleasing. Your completed implant will be fully functional, allowing you to resume normal activities.

Dentures

What are Dentures?

Dentures are replacements for missing teeth that can be taken out and put back into your mouth. While dentures take some getting used to, and will never feel exactly the same as one’s natural teeth, today’s dentures are natural looking and more comfortable than ever.

There are two main types of dentures: full and partial. Dr. Kuhl will help you choose the type of denture that’s best for you based on whether some or all of your teeth are going to be replaced and the cost involved.

How do Dentures Work?

With full dentures, a flesh-colored acrylic base fits over your gums. The base of the upper denture covers the palate (the roof of your mouth), while that of the lower denture is shaped like a horseshoe to accommodate your tongue.

Dentures are custom-made in a dental laboratory from impressions taken of your mouth. Dr. Kuhl will determine which of the three types of dentures described below is best for you.

Conventional Full Denture

A conventional full denture is placed in your mouth after any remaining teeth are removed and tissues have healed. Healing may take several months, during which time you are without teeth.

Immediate Full Denture

An immediate full denture is inserted immediately after the remaining teeth are removed. (Dr. Kuhl takes measurements and makes models of your jaw during a prior visit.) While immediate dentures offer the benefit of never having to be without your teeth, they must be relined several months after being inserted. The reason is that the bone supporting the teeth reshapes as it heals, causing the denture to become loose.

Partial Denture

A partial denture rests on a metal framework that attaches to your natural teeth. Sometimes crowns are placed on some of your natural teeth and serve as anchors for the denture. Partial dentures offer a removable alternative to bridges.

How Long Before I Get Used to My Dentures?

New dentures may feel awkward or uncomfortable for the first few weeks or even months. Eating and speaking with dentures might take a little practice. A bulky or loose feeling is not uncommon, while the muscles of your cheeks and tongue learn to hold your dentures in place. Excessive saliva flow, a feeling that the tongue does not have adequate room, and minor irritation or soreness are also not unusual. If you experience irritation, see Dr. Kuhl.

How Long do Dentures Last?

Over a period of time, your denture will need to be relined, remade, or rebased due to normal wear. Rebasing means making a new base while keeping the existing denture teeth. Also, as you age, your mouth naturally changes. These changes cause your dentures to loosen, making chewing difficult and irritating your gums. At a minimum, you should see Dr. Kuhl annually for a checkup.

Here are tips for caring for your dentures:

-When handling your dentures, stand over a folded towel or basin of water. Dentures are delicate and may break if dropped.
-Don’t let your dentures dry out. Place them in a denture cleanser soaking solution or in plain water when you’re not wearing them. Never use hot water, which can cause them to warp.
-Brushing your dentures daily will remove food deposits and plaque, and help prevent them from becoming stained. An ultrasonic cleaner may be used to care for your dentures, but it does not replace a thorough daily brushing.
-Brush your gums, tongue and palate every morning with a soft-bristled brush before you insert your dentures. This stimulates circulation in your tissues and helps remove plaque.
-See Dr. Kuhl if your dentures break, chip, crack or become loose. Don’t be tempted to adjust them yourself this can damage them beyond repair.

Extractions

Before removing a wisdom tooth, your dentist will give you a local anesthetic to numb the area where the tooth will be removed. A general anesthetic may be used, especially if several or all of your wisdom teeth will be removed at the same time. A general anesthetic prevents pain in the whole body and will make you groggy or cause you to sleep through the procedure. Your dentist will probably recommend that you don’t eat or drink after midnight on the night before surgery, so you are prepared for the anesthetic.

To remove the wisdom tooth, your dentist will open up the gum tissue over the tooth and take out any bone that is covering the tooth. He or she will separate the tissue connecting the tooth to the bone and then remove the tooth. Sometimes the dentist will cut the tooth into smaller pieces to make it easier to remove.

After the tooth is removed, you may need stitches. Some stitches dissolve over time and some have to be removed after a few days. Your dentist will tell you whether your stitches need to be removed. A folded cotton gauze pad placed over the wound will help stop the bleeding.

What To Expect After Surgery

In most cases, the recovery period lasts only a few days. Take painkillers as prescribed by your dentist or oral surgeon. The following tips will help speed your recovery.
-Bite gently on the gauze pad periodically, and change pads as they become soaked with blood. Call your dentist or oral surgeon if you still have bleeding 24 hours after your surgery.
-While your mouth is numb, be careful not to bite the inside of your cheek or lip, or your tongue.
-Do not lie flat. This may prolong bleeding. Prop up your head with pillows.
-Try using an ice pack on the outside of your cheek for the first 24 hours. You can use moist heat-such as a washcloth soaked in warm water and wrung out-for the following 2 or 3 days.
-Relax after surgery. Physical activity may increase bleeding.
-Eat soft foods, such as gelatin, pudding, or a thin soup. Gradually add solid foods to your diet as healing progresses.
-Do not use a straw for the first few days. Sucking on a straw can loosen the blood clot and delay healing.
-After the first day, gently rinse your mouth with warm salt water several times a day to reduce swelling and relieve pain.
-Do not smoke for at least 24 hours after your surgery. The sucking motion can loosen the clot and delay healing. In addition, smoking decreases the blood supply and can bring germs and contaminants to the surgery area.
-Avoid rubbing the area with your tongue or touching it with your fingers.
-Continue to brush your teeth and tongue carefully.
-Your dentist will remove the stitches after a few days, if needed.

Why It Is Done

A wisdom tooth is extracted to correct an actual problem or to prevent problems that may come up in the future. When wisdom teeth come in, a number of problems can occur:

Your jaw may not be large enough to accommodate them, and they may become impacted and unable to break through your gums.

Your wisdom teeth may break partway through your gums, causing a flap of gum tissue to grow over them. Food and germs can become trapped under the flap and cause your gums to become red, swollen, and painful. These are signs of infection.

More serious problems can develop from impacted teeth, such as infection, damage to other teeth and bone, or the development of a cyst.

One or more of your wisdom teeth may come in at an awkward angle, with the top of the tooth facing forward, backward, or to either side.

How Well It Works

Wisdom tooth removal usually is effective in preventing:
-Crowding of the back teeth.
-A wisdom tooth becoming stuck in the jaw (impacted) and never breaking through the gums.
-Red, swollen, and painful gums caused by a flap of skin around a wisdom tooth that has only partially come in.
-Gum disease and tooth decay in the wisdom tooth, which may be harder to clean than other teeth, or in the teeth and jaw in the area of the wisdom tooth.

Root Canal (Endodontics)

Root Canal, or endodontics, is the process of removing the nerves from the roots of a tooth. A root canal is often necessary to save an infected tooth. If an infected tooth is left alone for a long period of time, an abscess can form. An abscess will show up on an x-ray as a dark spot below the apex of the root. This is actually bone loss in the jaw. It is very important to catch this problem before it deteriorates too far.

Process

The first step of the procedure is to anesthetize the effected area. The next step is to open an access point through the top, or biting surface of the tooth. The doctor will then determine a working length of each canal. Each canal is then cleaned and shaped in preparation for the filling material. Once each canal is prepared, it is filled with an inert material called gutta percha. The canals are then sealed. The tooth is now ready for a restoration, which is usually a crown. This entire procedure is often completed in two visits.

Why do I need a root canal?

There are a number of reasons why one of your teeth may need a root canal. These include but are not limited to, a very deep cavity that extends into the nerve, a trauma to the tooth that exposes the nerve, or a crack in the tooth that extends into the nerve of the tooth.

Signs/Symptoms

-Moderate to severe lingering toothache pain when drinking hot or cold liquids or foods.
-Moderate to severe pain when biting on a tooth
-Sensitivity to tapping or pressure on the tooth
-Toothache that wakes you up in the middle of the night
-A pimple on your gum that may release pus or blood
-Radiating pain from one area of the mouth to another

Inlays/Onlays

Inlays and onlays are sometimes referred to as partial crowns. These partial crowns are utilized when there is still a healthy enamel portion of the tooth. An inlay or onlay is a like a puzzle piece that will be fitted into the remaining portion of the tooth to help increase its strength. This piece is usually crafted out of porcelain or gold, but can also be made of a composite material. We will make the determination as to which restoration will work best in your specific situation.

An inlay is used when there is not damage to any of the cusps of your tooth and is essentially place within these cusps. An onlay is used when there is slightly more extensive damage to the tooth structure. This type of restoration is placed over at least one of the cusps on the tooth.

Inlay Onlay Inlay Onlay

Procedure

When we have decided to go ahead with an inlay or onlay, we will set aside 2 appointments for the entire process. Although the majority of inlays and onlays are completed in two visits, there is sometimes a need for a third visit to ensure a proper fit.

The procedure begins with the removal of all decay in the tooth. Once we have removed the decay, we will take an impression of the tooth. This impression will be sent to our lab where your new restoration will be crafted. While this new tooth is created, we will provide you with a temporary restoration. Our temporary restorations will resemble your natural teeth so that you can continue with your daily life without worrying about a missing or incompatible tooth.

During your second visit to the office, we will proceed with the placement of your final restoration. The inlay/onlay will be fitted comfortably into the mouth. We will make every effort to ensure that the new restoration feels exactly like one of your natural teeth. The final step in the process is to cement the inlay/onlay into your mouth, leaving you with a beautifully restored smile.

Soft Tissue Grafting

Periodontal procedures are available to stop further dental problems and gum recession, and/or to improve the esthetics of your gum line.

Exposed tooth roots are the result of gum recession. Perhaps you wish to enhance your smile by covering one or more of these roots that make your teeth appear too long. Or maybe you are not bothered by the appearance of these areas, but you cringe because the exposed roots are sensitive to hot or cold foods and liquids.

Why do gums recede?

Your gums may have receded for a variety of reasons, including aggressive tooth brushing or periodontal disease. You may not be in control of what caused the recession, but prior to treatment Dr. Kuhl will help you identify the factors contributing to the problem. Once these contributing factors are controlled, a soft tissue graft procedure will repair the defect and help to prevent additional recession and bone loss. Where does the grafted tissue come from?

Soft tissue grafts are done when gingval tissue is absent due to recession. During this procedure Dr. Kuhl takes gum tissue from the palate and places it at the gingiva to further reduce the potential for any recession in the future. This can be done for one tooth to several teeth at the same appointment.