General & Cosmetic Dental Services

Veneers are a dental procedure in which a covering is placed over the outside (visible area) of the tooth. Veneers are usually only done to the 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. This method is usually referred to as bonding.

The indirect technique usually involves two appointments because the veneers will be fabricated at a dental laboratory. At the first appointment the teeth are prepared, impressions taken, and the teeth are given a temporary covering. In two to three weeks the veneers are back from the laboratory, 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 tooth material is removed, and the procedure is generally less uncomfortable. Veneers are not recommended for teeth that have large fillings or little tooth structure.

A dental implant is an ideal tooth restoration for people who are missing one or more teeth as a result of injury, periodontal disease, or any other reason. A dental implant is a metal post that a specialist or oral surgeon surgically positions into the jaw. Once in place and bone surrounding the implant has had time to heal, a replacement tooth is attached to the post. 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 since they do not depend on neighboring teeth for support.

Dental implants are placed by an experienced specialist who works closely with Dr. Skelton to achieve lasting function and exceptional esthetics.

Crowns and bridges are used to restore and enhance teeth that are damaged, or to take the place of missing teeth. A crown, also referred to as a cap, is used to entirely cover a damaged tooth. A crown not only strengthens a tooth, but it can dramatically improve a 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

Crowns and bridges are used to restore and enhance teeth that are damaged, or to take the place of missing teeth.

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 teeth on either side for support, hence the name. This is an 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. The materials used may be 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 aesthetics.

Dental sedation is a technique that can be used when a patient suffers from dental anxiety or dental phobia. We are happy to offer a number of solutions for our patients to make their dental visit as comfortable as possible. Sedation dentistry techniques enable patients – who might otherwise avoid the dentist – to receive dental treatment necessary for a healthy smile.

Depending on the extent of the anxiety or phobia, varying degrees of dental sedation can be utilized as described below.

Nitrous Oxide Sedation, also known as “laughing gas” is commonly used to make treatment more comfortable. This sedation is inhaled through a mask that allows you to breathe in the medication and induces a state of relaxation. Local anesthetic will be administered in conjunction with nitrous oxide to eliminate pain.

Oral Sedatives – This medication can be given to a patient the night before a dental procedure or 30 minutes to an hour prior to the dental appointment, depending on the severity of the anxiety. Oral sedatives do not provide pain relief, so an injection of local anesthetic will also be administered.

TMJ stands for temporal-mandibular joint. Temporal, as in temple area of skull; mandibular as in mandible, or lower jaw; joint as in it’s where the head and jaw meet. Problems in this joint may be caused by a misalignment of the teeth, trauma, or excess muscle tension. Aside from the two bones that meet there, cartilage buffers them and five muscles are involved in the area. If something goes wrong a good deal of trouble can result.

Problems in this area can cause:

• 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, etc. 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 untreated and taken to extremes, surgery may be required to repair a badly damaged joint.

A dental cleaning is a professional cleaning you receive from a dentist or dental hygienist. Most dental cleanings take only between 25 and 30 minutes. Cleanings should be performed every six months to prevent excessive plaque buildup. Plaque left untreated can lead to unhealthy gums and tooth decay. A routine dental cleaning should include scaling and polishing.

Scaling – this is the process of removing plaque and tartar from all tooth surfaces in a variety of methods, depending on the amount of plaque and tartar.

Dental hygienists traditionally perform scaling by hand. However, new and advanced technology has led to more modern methods such as electric scalers. This sophisticated tool allows dental cleanings to be performed more efficiently and in less time. To achieve best results, both electric and manual scaling methods are combined for dental cleanings.

Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when a cavity is allowed, through neglect, to reach all the way to the pulp. (Regular cleanings and checkups prevent and detect problems early). Sometimes deep restorations or trauma to a tooth may cause the nerve to be damaged to the point it needs root canal therapy, also. Once this occurs the pulp becomes infected, and can even extend through the root tip and begin to eat away at the surrounding bone (this is 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. This is dangerous, not to mention very painful. Symptoms that the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth.

Sometimes, however, no symptoms are apparent and the person is unaware of any problem until a checkup. A root canal is then 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) are filled in to prevent any further infection. Usually a core build-up and crown is recommended for restoring a tooth that has had root canal therapy.

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

There are a variety of filling materials available including plastic and porcelain. The dentist will work with you to determine which material is best for you, depending on the extent of repair, where in your mouth the filling is needed, and cost. Each of the filling materials is briefly explained below:

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

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

Custom designed mouthguards and nightguards are made of flexible plastic and molded to fit the shape of your teeth. Mouthguards are recommended to protect the jaw and teeth during physical activity and sports such as boxing, football, basketball, or other activities where your mouth may get hit. In addition, these guards protect the soft tissues of your tongue, lips and cheek lining. Nightguards are also recommended for patients who clench or grind their teeth at night as a way to protect their teeth and bite.

If you have decided a guard is right for you, the dentist will take an impression of your teeth which will then be sent to a lab to make a custom fit guard for you. In most cases you can choose from a variety of colors and styles for your guard. On average, guards last between 3 and 10 years.

Maintaining good oral hygiene is one of the most important things you can do for your teeth and gums. Healthy teeth not only enable you to look and feel good, they make it possible to eat and speak properly. Good oral health is important to your overall well-being.

Daily preventive care, including proper brushing and flossing, will help stop problems before they develop.

In between regular visits to the dentist, there are simple steps that each of us can take to greatly decrease the risk of developing tooth decay, gum disease and other dental problems. These include:

• Brush thoroughly twice a day and floss daily
• Eat a balanced diet and limit snacks between meals
• Use dental products that contain fluoride, including toothpaste
• Rinse with a fluoride mouth rinse if your dentist advises you to
• Make sure that your children under 12 drink fluoridated water or take a fluoride supplement if they live in a non-fluoridated area

X-rays are a focused beam of x-ray particles passed through bone which produce an image on special film, showing the structure through which it passed. This provides the familiar black and white images doctors and dentists use to diagnose problems and disease. 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.

In our office, we use digital radiography which allows us to take x-rays using up to 90% less radiation than conventional film x-rays. Using this technology, we are able to take an x-ray of your mouth by using a small sensor, which records the image of your teeth and sends it to a computer. The result is a highly detailed image of your mouth that can easily be enhanced to better diagnose dental concerns and determine the very best treatment for each case.

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.

Oral conscious sedation, or OCS, utilizes oral sedative medication to significantly reduce your fears and discomfort. OCS does not require needles to administer and is less expensive than IV sedation.

Benefits of Oral Conscious Sedation:

• It’s very effective for mild to moderate anxiety
• It’s safe and easy
• You can breathe and speak on your own
• It’s less expensive than IV sedation

In many cases, you can get ALL of your dental work done in one visit. Unlike general anesthesia, which renders patients completely unconscious, oral conscious sedation leaves you able to speak and breathe on your own. Although you will not actually be asleep, you will enjoy a heightened state of relaxation and probably won’t remember much about the procedure afterwards. Your appointment will be a dream and hours in the chair will feel like minutes.

Tooth whitening is a popular procedure to make 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, tooth whitening is a safe and relatively painless procedure ideal for most patients. Our office offers two methods of whitening: in-office whitening and tray whitening.

In-office whitening is an ideal procedure for anyone wanting immediate results. Because the entire procedure takes place in our office in about an hour, it is the perfect choice for busy individuals. In this process, a protective gel is applied to your gums to protect the soft tissue. An activated whitening solution is placed on the teeth that quickly and effortlessly brightens your smile. The result is dramatically whiter teeth that will last for years.

Tray whitening is a less expensive whitening treatment you can use while in the comfort of your own home to gradually whiten teeth. We will first take an impression of your teeth to create a customized clear tray that you will wear to whiten your teeth. Within a few days your trays will be ready to be picked up and we will show you how to apply the special bleaching material to the trays. The whitening gel trays should be worn 30-60 minutes up to twice a day. At the end of this period, you will see maximum whitening results that are nothing short of dazzling. Occasional treatment can be used at your convenience to maintain your new smile.

Bonding involves adhering composite resin material that is matched to the color of the tooth, to the front of the tooth. This is done to repair damage done to the tooth by decay, to alter the alignment of the tooth, close gaps between the teeth, or for cosmetic purposes. First the surface of the tooth is roughened in order to accept the bonding and hold it. A gel is applied to micro etch the tooth surface, and a primer/bond agent is applied so the material adheres to the surface. Then the material itself is placed on the tooth and hardened with intense light. The composite resin material is shaped and polished to get a lustrous finish as a last step.

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

Complete Dentures – This restoration method is used to restore your smile and mouth function if all your teeth have been lost. The dentures are custom created to resemble natural teeth and are positioned into a patients mouth to take the place of where the natural teeth used to be. Complete dentures are removable and may require adjustments in order to create a proper fit with the gums and mouth.

Partial Dentures – A removable partial denture is a device used when one or more natural teeth still remain in the upper or lower jaw. They usually consist of replacement teeth attached to a gum-colored plastic base which is held in place in the mouth. A fixed partial denture acts the same as a removable denture, but it is cemented into place using the adjacent teeth for support. This fills the space created by missing teeth, as well as creates a support for remaining teeth to prevent shifting.

Good oral hygiene should always be practiced since the loss of a single tooth can have major impact upon your oral health and appearance. Although dentists will use every measure to prevent tooth loss, there are still some occasions when a tooth may need to be extracted. A tooth may need to be extracted if the following occurs:

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

After careful examination and treatment, the dentist may advise to have a tooth extracted. Before a tooth is removed, the dentist will take an x-ray in order to understand the shape and position of the tooth and surrounding bone. Based on the degree of difficulty, we may refer you to a specialist called an oral surgeon.

A certain amount of pain and discomfort is to be expected following an extraction, which can be minimized with a pain killer and ice packs applied to the face for 15 minutes at a time. After a routine extraction, discomfort should lessen within three days to two weeks. If you have prolonged or severe pain, swelling, bleeding or fever, call our office immediately.

The gums, ligaments, and bone around the teeth form the foundation for one’s teeth. All structures are also referred to as the periodontium. When the periodontium is not healthy, it jeopardizes the teeth just as a bad foundation would threaten the stability of a house. Signs of unhealthy periodontium include: gums that are red and bleed easily, persistent bad breath, gums that are pulled away from the tooth, loose teeth, and changes in the position or bite of the teeth. Any of these may be a sign of a problem. With proper gum treatments, however, it may be possible to return gum tissue to a healthy state. If you’re having a problem, come in and see us so we may treat it right away. The treatment usually involves a deep cleaning or root planing done under a local anesthetic, along with local antibiotic agents. If the gum disease gets too severe it may need to be treated through surgery or extraction. This is why it is important to have it treated at the first sign of a problem.

Our office is a completely digital (paperless) dental office. This means all x-rays and charting are made and recorded with the aid of the computer. This technology allows us to maintain your dental records electronically, and cuts down the unnecessary paperwork used with traditional paper charting. Traditional paper charting is difficult to keep standardized from doctor to hygienist to assistant. Even handwriting differences and coding make the charts look different. The computer eliminates this problem by using consistent charting methods that are accurate and precise, making it easy to read your dental chart and see up-to-date information. Digital charting standardizes the charting process so it is clear, easy to understand, and enables us to provide the most accurate and precise care to our patients. When needed, this method also allows us to quickly and securely share information with your other health care providers.

We use small cameras about the size of a pen, called intraoral cameras, to help clearly see the condition of your teeth and gums.

With this advanced technology we can zoom in on small diseased areas, cracks, chips and worn metal fillings with extreme precision. The full-color images taken with the intraoral camera are sent to a computer screen so we can clearly see and diagnose dental problems much earlier than with traditional dental technology. Because images are displayed on our screens, patients will also be able to see areas being worked on and are able to gain a better understanding of dental procedures being performed.

Sealants are used to fill in narrow grooves in a tooth that cannot be adequately cleaned by brushing. In some cases, the tooth structure has fine grooves or pits which accumulate plaque, not because the person doesn’t brush, but because they’re too narrow to allow even one bristle into them. These will develop cavities over time, and you don’t want that. So the dentist will brush on a coating that seals the grooves and pits, making it possible to brush off all the plaque and keep your teeth healthy.

Our office utilizes a variety of methods to conveniently remind you of you scheduled appointment time. Email, text messaging and telephone reminders are among the options. You may decide with our scheduling coordinator which system best fits your lifestyle.

The dentist performs most of his dental procedures while wearing a pair of funny looking glasses called surgical telescopes. These powerful glasses have magnifiers on them, allowing the dentist to see fine details that would go unnoticed to the naked eye.

Our office utilizes electronic claims processing. This means that rather than sending your dental claim through the mail, it is sent electronically to your insurance company with the click of a button. By filing your claim electronically, information is submitted more efficiently and with fewer errors. This benefits our 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.

Halitosis is the sophisticated word for “bad breath”. Depending on the cause, bad breath may strike on occasion or may be a more persistent condition. The most common cause of bad breath is bacteria. Because the mouth is moist and warm, it creates perfect conditions for the millions of bacteria that live in the mouth. In fact, approximately 80% of bad breath is caused by something in the mouth.

Bad breath caused by bacteria in the mouth can easily be treated. Brushing your teeth, tongue and gums after meals as well as flossing and rinsing with mouthwash will usually take care of the problem. Regular visits to the dentist should be made for dental examinations and for professional teeth and gum cleaning.

Some types of bad breath, such as “morning mouth,” are considered fairly normal and are not usually health concerns. However, persistent bad breath may be a sign of more serious problems with the gums and teeth.

Bad breath may be caused by the following:

•  Poor dental hygiene – poor oral hygiene can leave food particles to decay in the mouth
• Infections in the mouth such as periodontal (gum) disease
• Respiratory-tract infections such as throat infections, sinus infections, lung infections
• External agents including foods such as garlic, onions, and coffee, as well as cigarettes and chewing tobacco
• Dry mouth caused by salivary gland problems or by breathing through the mouth
• Systemic illnesses such as diabetes, liver disease, kidney disease, lung disease, sinus disease, reflux disease and others

Call our office promptly if you have bad breath with painful, swollen gums that bleed easily or loose teeth. We will perform a physical examination of your mouth to determine the cause. If we discover that systemic problems are the cause, we may refer you to your family physician. In severe cases of gum disease, we may recommend a doctor specialized to treat gum disease called a periodontist.

Wisdom teeth are the last molars, or “third molars” that develop on each side of the jaws. Wisdom teeth 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, problems develop that require their removal. When the jaw isn’t large enough to accommodate wisdom teeth, they can become impacted (unable to come in or misaligned). 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 your mouth with a local anesthesia and may use oral sedatives so you can relax during the procedure.

After the tooth (or teeth) is removed, you may be asked to bite down softly on a piece of gauze for 30 to 45 minutes after you leave the office, to limit any bleeding that may occur. Some pain and swelling may occur but it will normally go away after a few days; however, you should call your dentist if you have prolonged or severe pain, swelling, bleeding or fever.