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5111 Maryland Way Suite 306 Brentwood, TN 37027 View Location

Services we provide

Initial Oral Examination | Periodontal Treatment | Root Canal Treatment | Mouth Guards | Bonding | Cosmetic Contouring | Crowns and Bridges | Procedures | Caring for your Crowns | Specialty Dentures | Types of Dentures | How are Dentures Made? | Getting Used to your Denture | Care of your Denture | Adjustments | Common Concerns | Denture Adhesives | Cosmetic Fillings | Grafts | Excessive or Uneven Gums | Implants | Whitening

Initial Oral Examination

Your initial oral examination includes a visual examination, charting, periodontal probing, diagnosis and treatment recommendations. We will also take x-rays, which include the panoramic x-ray for proper diagnosis of the anterior (front) and posterior (back) teeth, as well as the bite-wing x-ray series for proper diagnosis of proximal decay of posterior teeth.
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Periodontal Treatment

You should have a standard cleaning at least twice a year. A periodontal treatment includes an Adult Prophy (basic cleaning). If it has been over a year since your last cleaning, possible treatment will include either Periodontal Scaling (deeper) or Root Planning and Scaling (requires anesthetic).
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Root Canal Treatment

Inside of each of your teeth is a mass of nerves and other tissue called the "pulp." Occasionally, the pulp can become infected, causing pain and tooth decay. Endodontic therapy, also known as a "root canal," is a technique we use to remove the infected pulp and save the tooth, so an extraction is not necessary."

We perform endodontic therapy by drilling through the crown of the tooth, and cleaning out any damaged pulp. We then fill the gap and seal the tooth with a natural-looking porcelain crown.
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Mouth Guards

Whether you are an athlete or casual sports participant, you should wear a mouth guard to protect your teeth. If you grind your teeth while you sleep, a bite guard will help reduce symptoms of TMJ. We custom-make mouth guards in both soft and hard materials.
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Read the following topics to learn more about cosmetic procedures.

Bonding

An alternative to veneers is a process called bonding, in which a tooth-colored material that looks like the enamel of your teeth is molded and shaped, and then hardened and polished. Bonding can be used to improve the color of a tooth, or close unsightly gaps.

Bonding is generally not as permanent a process as veneers, and can be vulnerable to the same kind of staining to which your natural teeth are prone. Bonding can also be more prone to chips and cracks than veneers. Caps are generally preferred to bonding when such a procedure isn't deemed to be effective in the long run.
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Cosmetic Contouring

Teeth can become crooked, chipped, cracked, and even overlap as a result of many factors, including traumatic injury, bruxism (grinding) or even heredity. Cosmetic contouring and reshaping procedures can remedy, and in many cases, greatly improve these conditions. For example, an uneven or crooked tooth can be gently reshaped by removing a small amount of enamel, to correct the alignment.
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Crowns and Bridges

Bridges - Bridges are natural-looking dental appliances that can replace a section of missing teeth. Because they are custom-made, bridges are barely noticeable and can restore the natural contour of teeth as well as the proper bite relationship between upper and lower teeth.

Bridges are sometimes referred to as fixed partial dentures, because they are semi-permanent and are bonded to existing teeth or implants. Some bridges are removable and can be cleaned by the wearer; others need to be removed by a dentist. Porcelain, gold alloys or combinations of materials are usually used to make bridge appliances. Appliances called implant bridges are attached to an area below the gum tissue, or the bone.

Crowns - Crowns are synthetic caps, usually made of a material like porcelain, placed on the top of a tooth. Crowns are typically used to restore a tooth's function and appearance following a restorative procedure such as a root canal. When decay in a tooth has become so advanced that large portions of the tooth must be removed, crowns are often used to restore the tooth.

Crowns are also used to attach bridges, cover implants, prevent a cracked tooth from becoming worse, or an existing filling is in jeopardy of becoming loose or dislocated. Crowns also serve an aesthetic use, and are applied when a discolored or stained tooth needs to be restored to its natural appearance.
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Procedures

A tooth must usually be reduced in size to accommodate a crown. An impression is made of the existing tooth and an impression is made. The impression is sent to a special lab, which manufactures a custom-designed crown. In some cases, a temporary crown is applied until the permanent crown is ready. Permanent crowns are cemented in place. Crowns are sometimes confused with veneers, but they are quite different. Veneers are typically applied only to relatively small areas.
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Caring For Your Crowns

With proper care, a good quality crown could last up to eight years or longer. It is very important to floss in the area of the crown to avoid excess plaque or collection of debris around the restoration. Certain behaviors such as jaw clenching or bruxism (teeth grinding) significantly shorten the life of a crown. Moreover, eating brittle foods, ice, or hard candy can compromise the adhesion of the crown, or even damage the crown.
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Specialty Dentures

Dentures are designed to replace missing teeth, and are worn by millions of Americans. Technological advancements have resulted in dentures that are lightweight and mimic the look and feel of natural teeth. Most dentures are made from a combination of metals and synthetic material such as acrylic resin.
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Types of Dentures

Dentures are generally classified as partial or full. Partial dentures are designed to replace a small section of teeth, and help prevent existing healthy natural teeth from shifting position; full dentures generally replace an entire set of teeth such as upper and lower dentures. Many candidates for conventional dentures (also called "immediate" dentures) are able to wear the appliances immediately following removal of affected natural teeth. Before immediate dentures are worn, a mold of the patient's mouth – specifically the jaws – must be made in order for the dentures to be customized for the individual.

Partial dentures, also sometimes called "overdentures," are designed to fit over a small section of implants or natural teeth. Partial dentures are characteristic by their pinkish gum-like plastic bases, on to which replacement teeth are attached. Small clasps are used to attach the denture to existing teeth. Some clasps, which can be more expensive, are made of natural-looking material that is hard-to-detect. In some cases, a crown will be installed on an existing healthy tooth to facilitate a better hold for the clasp.
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How are dentures made?

Denture candidates can expect to have their appliances fitted after about five visits. The process takes about a month. During the first visit after diagnosis, your mouth and jaw are measured and an impression is made. The impression is critical for ensuring proper bite relationship, as well as the proper relationship of the appliance to the size of your face. After the impression is made, a temporary set of dentures may be applied so the patient can ensure that the fit, color and shape are suitable.
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Getting used to your denture

It takes some time to get used to new dentures. Wearers can expect this period of adjustment to last as long as two months. Some denture wearers need to wear their dentures without removing them for a certain period of time. This allows your dentist to make the critical initial adjustments for proper fit, and to identify any pressure points that may be causing discomfort.
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Care of your denture

Dentures today are made from very advanced materials designed to give you a natural appearance. However, keep in mind that just like your teeth, dentures should be cared for with diligence. This means daily brushing and regular visits to your dentist for minor adjustments. Just like natural teeth, dentures need to be cleansed of plaque, food particles and other debris.

Keeping your dentures in top shape will also help keep the soft tissues of your mouth healthy; an unclean or malformed denture can cause infections and irritation. Remember to rinse and brush your dentures after every meal, and soak them in denture solution overnight. This also allows your gums to breathe while you sleep.

Here are some simple techniques for keeping your dentures clean:

  • People can brush their dentures in a variety of ways. Some people use soap and water or a slightly abrasive toothpaste. Popular denture pastes and creams also can be used.
  • Avoid using highly abrasive chemicals or pastes, or vigorously brushing with hard bristled toothbrushes. These can scratch or even crack dentures.
  • Hold your dentures gently to avoid loosening a tooth.
  • Clean your dentures with cool or tepid water over a water-filled sink. Hot water may warp a denture. A small washcloth placed in the bottom of the bowl will ensure that your denture isn't damaged if it falls.
  • Soak your dentures overnight in any commercially available product like Efferdent or Polident and remember to rinse your dentures before placing them back in your mouth.
  • Remember to use a separate toothbrush to clean your own natural teeth, as well as all of your gum tissues.
  • In lieu of a toothbrush, a soft washcloth may be used to wipe your gums. Over time, even with daily care, your dentures may require cleaning by the dentist. A powerful ultrasonic cleaner may be used to remove hard accumulations of tartar and other substances.

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Adjustments

People's mouths undergo change all of the time. Gums change shape; in many cases, gums tend to shrink over time after teeth have been extracted. Most denture wearers experience a break-in period of as long as two months, during which the tissues surrounding their extracted teeth must heal. Conventional denture wearers must periodically visit their dentist to have the appliances adjusted. This is because patient's gums sometimes change shape or shrink; moreover, daily maintenance of the appliances over time may also obviate the need for minor adjustments.

Adjustments are critical because a loose-fitting appliance --or one that has not been adjusted to compensate for gum or jaw changes-- could cause pressure points, leading to mouth sores and possible infection. Regular dental visits also provide an opportunity to replace or repair loose teeth, or make small repairs to dentures that may have become chipped or cracked. Over the long run, the base of a denture may need to be "re-lined" because of wear and tear from constantly rubbing against your soft palate or roof of your mouth.
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Common concerns

Technology advancements have made dentures very natural-looking; however, it is only natural for first-time denture wearers to be self-conscious about their appearance and speech. Over time, a denture wearer's confidence level increases, and this usually ceases to be an issue.

Like any new thing, caring for dentures takes practice. Under normal circumstances, denture wearers can eat most foods with confidence that their appliance will not shift. Caution must be taken, however, to avoid certain kinds of hot, hard, crunchy, chewy or sticky foods. During the break-in period, denture wearers are usually advised to eat on both sides of their mouth so the appliances don't get out of balance, or tip to one side.
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Denture adhesives

In general, dentures that fit well may still need a small measure of help staying put. A good quality denture adhesive is acceptable. Older, poorly fitting dentures may damage the soft tissues of the mouth, and should be replaced as soon as possible.
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Inlays & Onlays

Inlays and onlays are restorations that are used when your tooth needs more than a simple filling, but does not need a full crown. They can restore strength and beauty to a tooth, with 75 percent less trauma than is necessary with a crown. Inlays are set into the space that is left when tooth decay is removed and bonded firmly into place. Onlays are similar, but they are larger, and are used to replace one or more of the tooth's cusps.
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Cerec 3D Technology

Crowns, inlays and onlays used to take several office visits to install. In the first visit, impressions of your teeth would be taken and then sent to an off-site dental lab where the crown would be made. Now, we use a new technology called Cerec 3D to craft porcelain restorations in our office, which means your whole crown installation can take place during a single office visit. Cerec restorations achieve much better aesthetics when compared to those made in an off-site lab; they are three times as strong as other restorations, and are even less expensive!
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Cosmetic Fillings

There are alternative, natural-looking materials to conventional silver-colored fillings – materials made from porcelain and composite resins, which are colored to match natural tooth enamel. Unfortunately, few materials can match the strength and durability of dental amalgam and such, may need more frequent replacement. Common amalgam alternatives include:!

  • Composite fillings -- As stated, composite fillings are just what the name implies: a mixture of resins and fine particles designed to mimic the color of natural teeth. While not as strong as dental amalgam, composite fillings provide a pleasing aesthetic alternative. Sometimes, composite resins need to be cemented, or bonded to a tooth to allow for better adhesion.
  • Ionomers -- Like composite resins, these materials are tooth-colored. Ionomers are made from a combination of various materials, including ground glass and acrylic resins. Ionomers are typically used for fillings near the gum line or tooth root, where biting pressure is not a factor. They are more fragile than dental amalgam, however. A small amount of fluoride is released by these compounds in order to facilitate strengthened enamel in the affected area.
  • Porcelain (ceramic) -- This material is usually a combination of porcelain, glass powder and ceramic. Candidates for porcelain fillings are typically crowns, veneers and onlays and inlays. Unlike ionomers, porcelain fillings are more durable but can become fractured if exposed to prolonged biting pressures.
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Grafts

Soft tissue grafts are small pieces of tissue taken from other areas such as the palate and surgically implanted in the affected area. Grafts can correct dental deformities and other problems such as severe gum disease, as well as cover exposed roots, stop bone loss, the recession of gums, and even reduce pain-causing root sensitivity.
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Excessive or Uneven Gums

Many people inherit the problem of excessive or uneven gums.A cosmetic surgical procedure called a gum lift can be used to correct this problem.Some abnormalities, as well as advanced gum disease that cannot be treated periodontically or nonsurgically, may require application of soft tissue grafts. Such procedures can be used to cover an exposed root or correct uneven gum lines.
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Implants

Before development of dental implants, dentures were the only alternative to replacing a missing tooth or teeth. Implants are synthetic structures that are placed in the area of the tooth normally occupied by the root. Implants are anchored to the jawbone or metal framework on the bone and act as a foundation for an artificial tooth or permanent bridge. In some cases, implants can be used to attach dentures.

  • Not everyone is a candidate for a dental implant. For a successful implant to take hold, a candidate must have proper bone density and have a strong immune system.
  • Implants are so well-designed, they mimic the look and feel of natural teeth. Implants are usually made of titanium.
  • In general, good candidates who have dental implants can expect high success rates with the procedure.
  • The procedure can take several visits. During the first visit, an anchor is placed into the jawbone and the site is allowed to heal for several weeks or months. This gives your tissue time to grow around the anchor to more firmly hold it in place.
  • During a follow-up visit, an artificial, natural-looking tooth is fitted over the implanted anchor.

Types of Implants

Various types of implants include full upper and lower, anterior, posterior, and single-tooth.

Full upper replacements - The upper set of teeth is replaced with implants. Procedure steps include:

  • Missing tooth roots are replaced with implants, which are covered under the gum line.
  • A healing period of up to six months allows implants to take.
  • The implants are uncovered and extensions attached.
  • Replacement teeth are affixed to the implants and extensions. In some cases, full upper replacements can be removed.

Anterior replacement - Implants are used to replace the front teeth (also called incisors and cupids). Procedure steps include:

  • Missing tooth roots are replaced with implants, which are covered under the gum line.
  • A healing period of up to six months allows implants to take.
  • The implants are uncovered and extensions attached.
  • Replacement teeth are affixed to the implants and extensions.

Full lower replacement - The lower set of teeth is replaced with implants. Full lower replacement usually only uses four to six implants (near the front), which are used to anchor a denture. This obviates the need for denture adhesive.

Posterior replacement - Implants are used to replace the bicuspids and molars (the back teeth). Procedure steps include:

  • Missing tooth roots are replaced with implants, which are covered under the gum line.
  • A healing period of up to six months allows implants to take.
  • The implants are uncovered and extensions attached.
  • Replacement teeth are affixed to the implants and extensions.

Single tooth replacement - Procedure steps include:

  • Missing tooth roots are replaced with implants, which are covered under the gum line.
  • A healing period of up to six months allows implants to take.
  • The implants are uncovered and extensions attached.
  • Replacement teeth are affixed to the implants and extensions. In some cases, full upper replacements can be removed.
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Veneers

In just two or three dental visits, a veneer can reverse years of stains caused by foods, caffeine and tobacco use. Special thin laminates, called veneers, can also be used to correct discolored, worn down, cracked and chipped teeth. Veneers can also be used to close unsightly gaps between teeth. Stronger types of veneers made of porcelain, also called composite veneers, typically last longer because they are bonded to the tooth. An impression of the tooth must be made and a veneer molded by a lab technician. Because veneers require a small amount of enamel to be removed, they are permanent and non-reversible. The process involves buffing the tooth, removing an extremely thin layer of the tooth to allow for the thickness of the veneer, an impression of the tooth, and final bonding of the veneer to the tooth with special cement. A special light is used to complete the process.
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Whitening

Often, people with stained or discolored teeth may just need a whitening procedure in order to restore their smile. People with stained or dull teeth usually benefit from whitening, which is a safe and effective way to brighten stained, discolored or dull teeth. Even a stubborn single tooth that is noticeably duller or less white than your other teeth can be individually brightened.

Teeth bleaching products, which contain peroxides, actually change your natural tooth color anywhere from five to seven -- but even up to twelve -- shades brighter. One process known as chairside bleaching involves applying either a protective gel to your gums or a rubber shield to protect the soft tissues in the mouth. A bleaching agent is then applied to the teeth, and a special light is used to enhance the chemical action. If your teeth aren't very dark or very stained, you may need only one bleaching session.

Tooth bleaching safely lightens the color of your teeth, and can last up to a year before a touch-up is needed. In general, bleaching works for most people. Tooth bleaching is most effective if your teeth are darkened from age, coffee, tea or smoking. Teeth darkened with the color of yellow, brown or orange respond better to lightening. Other types of gray stains caused by fluorosis, smoking or tetracycline can be lightened, but with less-than-satisfactory results.

If you're interested in brightening your smile, have your teeth evaluated by us. Not everyone is a good candidate for bleaching. In some cases of serious discoloration and pitted teeth, for example, veneers may be more appropriate than bleaching. Moreover, crowns, bridges, and fillings do not bleach, so it may be necessary to replace dental work to make it blend with the new color of your bleached teeth. An X-ray of your teeth may be the only accurate way of making a true assessment.
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