First Impressions: Our Services

OUR SERVICES:

BONDING
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.

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BRIDGES
This is an option for filling the space created by a missing tooth. It is formed to look like the missing tooth, and it takes its place in the mouth. The sides of a bridge use the two surrounding teeth for support, hence the name. A bridge replaces the missing tooth, both functionally and cosmetically. Bridgework 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 (tooth colored) material. The choice of material depends on requirements for strength, wear, and/or esthetics.

It is important that a missing tooth be replaced as soon as possible for several reasons. If not treated the teeth surrounding the gap can begin to shift or tip inward. This creates additional stress on the teeth and on the muscles and jaw joints. If nothing is done to replace the missing teeth, the force and stress on the remaining teeth and on the muscles and jaw can cause breakdown of these systems. Teeth can break or supportive bone can be damaged and cause tooth loss. Muscles can become hyperactive (spasm) and cause headaches, jaw pain, and even damage to the jaw joint itself.

COSMETIC DENTISTRY
This can be anything done to correct imperfections with the appearance of the teeth. Anyone who is unhappy with their smile can have it fixed. The upper teeth show, usually, only when smiling, while the lower teeth remain hidden. This is reversed when talking. The upper teeth remain hidden while the lower teeth show. The color, alignment, spacing as well as shape of the teeth are the characteristics that give the overall appearance. Any of these can be repaired or altered to give a stunning and different look to the mouth.

At First Impressions a wide selection of cosmetic dental options are available. Some of these options are tooth whitening, smile design, re-contouring (reshaping) of the teeth, veneers (porcelain covers for the teeth), bonding (tooth colored fillings), and all ceramic/porcelain crowns.

CROWNS
Crowns are full coverage restorations that are used to cover a tooth that is likely to break, or is too broken down to be restored with a filling. They are most commonly done after root canal treatment, or when a large filling wears out. The larger the hole made by a cavity that has to be treated, the more likely a crown will be needed. Even after a filling is put in a large cavity, a tooth is more likely to break. Keep in mind that the jaw muscles are the strongest in the human body. Teeth are subjected to tremendous pressures. Crowns ride over the weakened tooth, providing strength and protecting the tooth against breakage. A broken or cracked tooth is a far more serious matter and much more difficult to treat. Crowns prevent this, as well as making for a nice smile.

It takes two appointments to restore a tooth with a crown. In the first any decay is removed from the tooth and it is shaped to accept the crown. Then an impression is made of the tooth for use in fabricating a crown. Between the two visits the crown is made, usually of high-strength porcelain over gold alloy, all ceramic material, or gold. During this time a temporary crown is worn. In the second visit this temporary is removed. Then the permanent crown is adjusted as needed and then cemented in place.

DENTURES
There are different types of dentures, but they share their common function. They replace teeth that have become loose or been lost due to bone loss, decay, or trauma (an injury). No one enjoys losing their natural teeth, but with dentures you can regain your smile and some of the chewing function of your natural teeth.

The entire mouth is examined and a determination is made as to which teeth will have to be removed, and which will remain. A treatment plan is developed outlining the steps to replace/repair the teeth.

Partial Dentures are dentures that clip to any remaining teeth for support. Partial dentures have a metal and plastic base for strength and because they clip to natural teeth, they can be made to fit very tightly.

Full or Complete Dentures are dentures that replace all the teeth in the upper or lower jaw. They have a thick plastic base for strength and look and function similar to natural teeth.

If all the lower teeth are missing or if they need to be removed and replaced with a complete lower denture, implants (see implants below on this page) are very helpful in making the denture more stable when chewing and talking.

At First Impressions, Dr. Lerohl and Dr. Landers will take the time to discuss all these options and answer any questions or concerns you may have before treatment is started.

FILLINGS
Fillings are done to remove decay, and replace the affected tooth structure. It is called a filling because new material fills the hole that the decay left behind. Today, most teeth are treated (filled) with bonded tooth colored composite resin fillings. Caught early enough, cavities can be treated easily and painlessly. If not treated decay can lead to tooth pain and/or infection, and the tooth could need root canal treatment or even need to be extracted.

IMPLANTS
Dental Implants are one option to replace a missing tooth or teeth. In this procedure, a small titanium shaft replaces the root of the missing tooth. It is surgically implanted into the bone and allowed to heal. The bone grows around it forming a tight connection, which additionally slows or stops the bone loss that occurs when the root of a natural tooth is missing. Once the implant has healed (usually 3 to 6 months), the dentist works to attach the replacement tooth onto the top of the shaft. This permanent solution has some advantages over bridgework in that it does not need to use the surrounding teeth for support.

Implants can also be used as support for an implant bridge or denture. An implant bridge is an alternative to partial dentures, and has several advantages. First, there is no adjustment period for the patient to get used to wearing the partial denture. Once the work is done, the patient only feels teeth, not the metal supports of the partial denture in the mouth. Second, the implants slow the bone loss that usually occurs when teeth are missing. Third, they don’t have to be taken out for cleaning!

Implant supported dentures are an excellent way to make loose or ill-fitting dentures more stable and allow the patient to chew and function better and more comfortably. As discussed above, a titanium shaft is placed into the bone and allowed to heal. After healing, attachments are placed onto the titanium shaft and counter attachments are placed into the denture. The denture then “snaps” into the implants and is much more stable than a traditional denture. Also, the implants help maintain the bone levels around them, so there is less bone loss in the mouth when implants are present.

LASER DECAY DETECTION
Laser decay detection uses a small handheld diode laser to scan the surfaces of your teeth. As the light goes along, any areas of decay show up. This is because healthy tooth material does not fluoresce (glow) under the special light. Decayed tooth material, however, shows up clearly. This allows us to see forming cavities months or years before they will ever show up on x-rays. This early detection makes it very easy to catch small problems long before they get a chance to become big problems.

NITROUS OXIDE (LAUGHING GAS)
Now, this isn't really a service in itself, but it is used to make other treatment more comfortable. This is the famous dental anesthetic. It's safe, has been proven effective over a long period of time, and is pleasant. You will be given a scented mask that allows you to breathe in through your nose and out through your mouth. In about 30 seconds to 4 minutes you will notice a more sedate feeling, and your cheek and gums may go numb. After this any needed local anesthetic is applied and treatment begins. Afterwards, you will be given pure oxygen to breathe for about five minutes to dissipate the effects of the nitrous and return you to a normal state. There is no charge for nitrous oxide in our office, so if you are apprehensive about dental treatment, it can be a big help in keeping your mouth healthy.

NON-SURGICAL GUM TREATMENTS
The gums, ligaments, and bone around the teeth form the foundation and support for the teeth in our mouths. These 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 (gum disease) may be as follows: 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 signs may mean something is wrong. With the proper care, however, it may be possible to return them to a healthy state. This is where appropriate gum treatments come in. If you're having a problem, come in and see us so we can take care of it right away. The treatment usually involves a deep cleaning (gum therapy) which is done under a local anesthetic, along with local antibiotic agents. If the gum disease gets too severe it may need to be treated through gum surgery or in some cases removal of the teeth. This is why it is important to get it treated at the first sign of a problem.

ROOT CANAL TREATMENT
Root canal treatment (also referred to as root canal therapy or endodontic therapy) is necessary when a cavity, through neglect, reaches all the way to the nerve tissue inside the tooth. Sometimes deep restorations (fillings) or trauma to a tooth may cause the nerve to be damaged to the point it needs root canal therapy.

Once this occurs the nerve becomes infected, and can even extend through the root tip and begin to eat away at the surrounding bone (this is called an abscess). By the time the nerve is infected it must be treated because it cannot heal on its own. Infected teeth can even weaken the body’s entire immune system. This is dangerous, not to mention very painful. Symptoms that the nerve 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 nerve, and disinfect the inside of the tooth. Once the infection is resolved, the canal(s) are filled in to prevent any further infection. Following root canal therapy, it is necessary to cover the tooth with a crown to prevent the tooth from fracturing or breaking. A root canal and crown can be done in two visits in most cases – usually 2 hours for the first appointment and then only 20 minutes for the second appointment 3 weeks later.

SEALANTS
This is 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.

TMJ TREATMENTS
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.

TOOTH WHITENING
This is the procedure of making teeth whiter, and therefore more attractive. Our office uses a take home method that involves wearing custom vinyl trays a few hours very night for about 4 to 6 weeks to brighten the teeth.

The tray method involves having impressions taken from which laboratory fabricated custom vinyl trays are made. A carbamide peroxide gel is placed in these trays and the trays with gel are worn for about 2 hours every night. The entire process takes 4 to 6 weeks of daily use. After the initial whitening is completed, just “touch up” the teeth every 6 months by wearing the tray for about 2 hours twice a year. This will keep the color from fading back.

Our office regularly runs bleaching specials for only $99.00 for the take home bleaching trays and bleaching kit! Keep your eyes open for these special “white sales” because they can save you almost $300.00 from the regular price!

X-RAYS
This is a focused beam of X-Ray particles that passes through the teeth and bone to produce an image on special film, showing the structure through which it passed. This gives the familiar black and white images that doctors and dentists use to diagnose problems. X-rays are a necessary part of the diagnostic process, and not to use them could lead to undiagnosed disease. Without an X-ray of the whole tooth, and supporting bone and gum tissues, there is no real way to detect infection or pathology that requires attention.

X-Rays are usually taken once a year at regular cleanings and for any emergency treatment that may need to be provided. We recommend a full set of X-Rays (about 18 pictures) every 5 years to help us detect any diseases that may be present, but not visible in the mouth, supporting structures of the teeth, and the teeth themselves.

VENEERS
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 very esthetic.

The advantage of veneers versus crowns is that much less tooth material is removed, and the procedure is generally less uncomfortable. Veneers are recommended for teeth that have large fillings or little tooth structure.