BioClear

BioClear

Treating black triangles, gaps and restoring ANTERIOR AND posterior teeth with BioClear Injection Molding Technique

 

As we age, sometimes unwelcome dark spaces appear between our teeth.  Besides adding an older appearance to our simile, these dark spaces may also collect food debris and plaque. Also known as dental black triangles - the clinical terminology is gingival embrasures - they can be the result of bone loss, recession of the gum line, or movement of the teeth.

Some people have naturally occurring gaps between their teeth called diastema.  Though not unhealthy, gaps between the teeth are sometimes the source of embarrassment or low self-esteem.

Until recently, dentists repaired “black triangles” and gaps with porcelain veneers.  A method for restoring function and appearance, veneers are thin layers of ceramic that adhered to the teeth.  Applying the veneer, though, first involved removing portions of the tooth surface to make room. With BioClear, the natural tooth can be preserved so there is no additional loss of minerals. The BioClear technique achieves aesthetic beauty in a healthy way.

BioClear is also beneficial for posterior teeth. For posterior teeth, the Injection Molding Technique can many times be used to  prevent  having to place crown. There are clear indications to get a crown, but now we can restore teeth with this technique which before we had only the option of placing a crown. 

This technique uses addition instead of amputation,which  strengthens  the tooth. In addition, it is a more cost effective and conservative approach.

BioClear Injection Molding Technique is a new system that uses composite material, easily bonded to any part of the tooth, to close the gaps, align uneven teeth, cover chips and even out the color.  It is minimally invasive and cost effective treatment that uses clear forms which are filled with a composite material matched to the shade of your teeth.  The forms are removed leaving behind smooth contoured composite that has beautiful shine this is smooth to the touch.  The form sits just below the gum line, meaning the teeth will appear to emerge naturally.  The tight contacts achieved with this system mean that the papilla (the gum in-between the teeth) is hugged back into place, revealing a healthy and youthful smile.

Screen Shot 2018-03-15 at 11.45.02 AM.png
 BEFORE  This patient came to Family Holistic Dentistry because she didn't like the appearance of her veneer in her lateral incisor  and needed to start a new job. She  couldn't neither afford  nor wait for a new veneer. BioClear was a great option for her,  we removed the old veneer and did a BioClear restoration for her with a BPA free and Fluoride free composite. 

BEFORE

This patient came to Family Holistic Dentistry because she didn't like the appearance of her veneer in her lateral incisor  and needed to start a new job. She  couldn't neither afford  nor wait for a new veneer. BioClear was a great option for her,  we removed the old veneer and did a BioClear restoration for her with a BPA free and Fluoride free composite. 

 AFTER  The result: a more natural and  beautiful restoration than a veneer and less expensive as well. In addition she got it in one appointment and won't come off as veneers do sometimes. After 1 hour she was ready to start her new job. Later she will come back for us to fix her central incisor.

AFTER

The result: a more natural and  beautiful restoration than a veneer and less expensive as well. In addition she got it in one appointment and won't come off as veneers do sometimes. After 1 hour she was ready to start her new job. Later she will come back for us to fix her central incisor.

As we age, sometimes unwelcome dark spaces appear between our teeth.  Besides adding an older appearance to our simile, these dark spaces may also collect food debris and plaque. Also known as dental black triangles - the clinical terminology is gingival embrasures - they can be the result of bone loss, recession of the gum line, or movement of the teeth.

Some people have naturally occurring gaps between their teeth called diastema.  Though not unhealthy, gaps between the teeth are sometimes the source of embarrassment or low self-esteem.

Until recently, dentists repaired “black triangles” and gaps with porcelain veneers.  A method for restoring function and appearance, veneers are thin layers of ceramic that adhered to the teeth.  Applying the veneer, though, first involved removing portions of the tooth surface to make room. With BioClear, the natural tooth can be preserved so there is no additional loss of minerals. The BioClear technique achieves aesthetic beauty in a healthy way.

BioClear is also beneficial for posterior teeth. For posterior teeth, the Injection Molding Technique can many times be used to  prevent  having to place crown. There are clear indications to get a crown, but now we can restore teeth with this technique which before we had only the option of placing a crown. 

This technique uses addition instead of amputation,which  strengthens  the tooth. In addition, it is a more cost effective and conservative approach.

BioClear Injection Molding Technique is a new system that uses composite material, easily bonded to any part of the tooth, to close the gaps, align uneven teeth, cover chips and even out the color.  It is minimally invasive and cost effective treatment that uses clear forms which are filled with a composite material matched to the shade of your teeth.  The forms are removed leaving behind smooth contoured composite that has beautiful shine this is smooth to the touch.  The form sits just below the gum line, meaning the teeth will appear to emerge naturally.  The tight contacts achieved with this system mean that the papilla (the gum in-between the teeth) is hugged back into place, revealing a healthy and youthful smile.

Screen Shot 2018-03-15 at 11.44.35 AM.png

 

This procedure is much less expensive than porcelain veneers, can be completed in one visit, is stain resistant and durable, and closes up the unsightly “black triangles.” There is no need to remove enamel or grind a tooth prior to application.

If your teeth are healthy (meaning there is no decay or significant damage that would require a crown to repair) BioClear may be a good option for you.  It is minimally invasive and your teeth will look healthy and gap-free.

Dr. Burke has completed level 4.0 BioClear Matrix courses at the BioClear Learning Center in Tacoma Washington and is fully certified in this technique. BioClear fits into her philosophy of conservative, minimally invasive dentistry.

To learn about BioClear please contact us at Family Holistic Dentistry 303-219-0499

 

 

Another Clinical case at Family Holistic Dentistry

This patient came to our office asking for Bioclear to close his black triangles.
He had ortho( braces twice) and the space between his front teeth couldn’t be closed by that treatment. He was very uncomfortable after getting a dental cleaning every 6 months because he could see his black triangles more pronounced. His self stem was affected by that.
He wanted to get an alternative to close them with a natural look.

We closed them with BPA free composite.
He loved the technique, not post sensitivity, youthful look

https://drcarmenburke.com/service/bioclear

Adam 2.jpg
Adam 3.jpg
Adam 4.jpg

Chemical-free environment

Chemical-free environment

At Family Holistic dentistry we avoid all chemicals as much as possible; we clean with eco-friendly, non-scented materials, and staff does not use perfume or other synthetic fragrances. One in three individuals in the US has chemical sensitivity so we limit the exposure as much as possible for our patients and their families. We want our patients to feel comfortable and safe from overexposure to chemicals and synthetic fragrances when they are here.

To ensure clean air in the office, we have a Vollara air purifier, with an ionizer. It has negatively charged ions  which remove pollutants from the air. ActivePure Technology duplicates nature to safely reduce contaminants on surfaces.

We have an Amalgam separator to  protect the water of Boulder and be complaint with the EPA (Environmental Protection Agency)  final rule on amalgam separators.

 Amalgam separators remove amalgam particles from the wastewater to reduce the amount of amalgam entering the sewage system.  

Refreshments are limited to tea, to avoid offering anything that might have a negative impact on our patient’s health and filtered and purified water, using The Berkey filter , which has  the technology of  ionic absorbtion  to purify water and it is able to handle the very smallest of water contaminants, even viruses. 

We only use Nitrile gloves and  non latex rubber dam  to avoid adverse reactions in patients allergic to Latex.

We carry some special instruments without metal for people that has metal sensitivity or have reacted to dental instruments in the past. Please let us know if that is your case  when you make the appointment and we will have those ready to use for your dental procedure.

We use a diffuser with essential oils  to have the benefits of aromatherapy , when our patients request it.

We  disinfect and sterilize all our instruments , burs and hand pieces  in individual packages  after each use to follow OSHA regulations and protect the health of our patients and ours.

We don't have pets in our office. 

We have the  CT and the digital sensor  with the lowest radiation in the market

https://drcarmenburke.com/service/digital-x-rays

  At family Holistic Dentistry we want our patients to feel at home! 

 

 

multiple chemical sensitivity image.jpg

Ozone Therapy(O2/O3)

IMG_9544.jpg

Ozone Therapy(O2/O3)

Ozone is made up of three oxygen atoms.  It is the elemental form of oxygen that occurs naturally as a result of ultraviolet light in combination with atmospheric electrical discharge, or lightning, which causes a temporary recombination of oxygen atoms into groups of three. An ozone generator simulates lightning via an electrical discharge field.  Ozone is also formed naturally in our bodies by the immune system to kill invading bacteria, viruses,protozoa,  parasites and fungus. It works because oxygen is the only gas that has a terminal electron receptor and can carry an electrical charge.

Ozone is an anti-inflammatory and has strong disinfectant properties. It enables non-toxic wound healing.  It increases circulation via nitric oxide and has high redox potential.  Ozone is a powerful oxidizer, and therefore it is a great natural therapy to address infections commonly seen in the oral cavity.

Ozone enhances gum treatment,  root canals, extractions, and even cavity prevention. Gum disease is a result of multiple factors including diet, systemic conditions,type of bacteria and oral hygiene habits. Ozone therapy improves the state of the gums while reducing the unhealthy pressures on the overall system.

In our practice, we are irrigating with ozonated water along with scaling the teeth. This is followed by an infusion of gas directly into the gum pockets. Using this method, we virtually eliminate pathogens. In addition, the gums respond with increased blood flow and healing. Patients can augment this treatment at home with ozonated olive oil. The methods applied are safe and efficacious, with no toxicity or side effects. If you need to be referred to a periodontist, we'll be more than happy to do so. 

Ozone is equally as promising in root canal treatment. We can further eliminate other toxins by offering ozonated products as an alternative to conventional chemicals. Ozone disinfects the potential chronic state of infection surrounding a root canal-treated tooth. Ozone gas permeates and disinfects throughout the lateral canals and tubules in a tooth. The bacteria in the tooth create a positive charge. Ozone, as it is the only gas to carry an electrical charge, gets attracted to the very infection it is trying to fight. The pathogens attract the ozone, essentially committing suicide. Thus, concerns affiliated with root canals can be reduced.We will refer you to an endodontist when the case demands that.

Ozone is also being used to stop small cavities and to inhibit deeper cavities from degenerating into root canals. It is especially useful for treating cavities in the children as minimal drilling is all that is required. I have treated small children with ozone trays who were recommended to be put under general anesthesia.  We used ozone trays, advised parents on habit adjustments and nutritional counseling in order to buy some time, and we slowly started filling their teeth individually as the child matured. 

Dr. Burke is certified in Ozone Therapy from the American College of Integrative Medicine and Dentistry.  We use a state of the art medical grade ozone generator manufactured by Longevity Resources, which produces ultra-pure, contaminant free ozone from pure oxygen.

IMG_9542.jpg

Pediatric Dentistry

Pediatric Dentistry

IMG_9460_1.jpg

We are a family practice and we love seeing kids. Kija, My office manager and I are both mothers with young children and we understand how important it is for children to grow up with positive experiences at the dentist. In addition, Natalie our dental assistant is a young lady with great empathy to kids.  When you and your child come for your first visit and examination, we will cover good hygiene practices that you can do as a parent to help improve your child’s overall dental health. A good diet is necessary for oral health, and it is important to start emphasizing the influence of a proper diet early on in your child's life.  We’ll teach you how to brush and floss your child's teeth.  You can watch a video where I am brushing my daughter's teeth. 

We do our best to give kids the best experience in our practice!

It is our goal to help your child avoid preventable cavities.  Your child’s primary teeth are very important in the preparation and establishment of their permanent teeth.  It is vital that your child’s primary teeth are left in until they are naturally lost. Primary teeth serve three main roles: They support the permanent teeth by saving space, they help your children chew their food properly, and they aid in the progress of speech development.

We have a small area for kids in our office with a table,toys, pencils, colors, books,coloring books and coloring paper to facilitate their transition to the dental chair. 

 

IMG_9456_1.jpg

If you child does need dental work done, we will use only the cleanest materials. We are a mercury  and fluoride free office and use BPA free sealants and composites. We use only materials recommended by the IAOMT, the professional organization which monitors holistic dentistry.  We also can incorporate ozone into treatments.  I had four families with very young children come to us last year who had a child that had intensive decay.  It was recommended to put them under general anesthesia to perform their dental treatment.  Instead, we used ozone trays, advised parents on habit adjustments, and gave nutritional counseling in order to buy some time. We then began filling the child's teeth individually as they matured. Those kids have responded very well to the treatment.

" We had a wonderful experience working with Dr. Burke. We found out our little baby 2 year old had decay, it was devastating. This was also a shock to us at the time as you couldn't even see it. We were referred to a pediatric dentist and were told to have her put under anesthesia and crown 8 of her teeth. This all started when she was about 1 1/2. We were not comfortable with this recommendation. No she wasn't eating sweets, it turns out to have been a perfect storm. She was almost exclusively breastfed but when solids were introduced she wasn't getting properly rinsed before nursing. She has a lip tie. She drank out of a water bottle with a straw. She also was very resistant to brushing and I wasn't pushy about it. So her brushing was probably not proper, I figured eventually she would get used to it. There were certainly other factors as well. But again shocking as our family has a healthy diet and lifestyle and great oral health. Anyway, we opted for strict diet changes, supplementing and a more confident approach to brushing and we halted her decay. I wrote a letter to Dr. Burke explaining our situation and asked for an appt. we were coming from ND. She was so wonderful, worked with us and put a long appt on her schedule. We had been preparing for the appt by playing dentist etc. and Dr. Burke just made everything go very smoothly. It turned out we were right her decay had halted and her spots were hard. Except one, which was hard to reach. Dr. Burke filled that one and used ozone. Our daughter needed many breaks and she just was so accommodating and very gentle. It went much smoother than ever expected. Thank you Dr. Burke, it was wonderful having you work with our daughter."

https://www.google.com/search?q=carmen+burke+dds&oq=carmen+burke+dds&aqs=chrome..69i57j69i60j69i61l2.4332j0j4&sourceid=chrome&ie=UTF-8#lrd=0x876bedce49330157:0xc2cad1e2f67835a8,1,,,

 

In addition, if your child has any chemical sensitivities we can do materials testing reactivity.  

 

We are a dental practice fit for the entire family and promise to treat your kids the way we would treat our own.

Services offered for kids in our office:

  • Cleanings with ozone

  • Ozone trays

  • BPA free sealants and composite fillings

  • Extractions

  • Appliances such as space maintainer

  • Frenectomies

  • Second opinions

  • Evaluation of the space available for the permanent teeth

  • Remineralization with alternatives to fluoride

 

 

Safe Amalgam Removal

ama 3.jpg

Safe Amalgam Removal

Having an amalgam silver filling removed exposes you to mercury vapor. When you have this procedure performed in a mercury-safe environment, your exposure is drastically reduced.

As a SMART certified member of the IAOMT(International Academy of Oral Medicine and Toxicology), I have been trained on how to remove amalgam silver fillings safely, in order to protect the patient, the assistant, and everybody present at the dental office. See the link  "office handout  about SMART"on the bottom of the page to get more information about SMART(safe mercury amalgam removal technique).

Safe Amalgam Removal Protocol is Detailed Below:

1. We give the patient a rinse with  activated charcoal or chlorella  before and after the procedure

2. The patient  wears a transparent oxygen mask ,eye protection,nitrile gloves, a bib,a disposable and impermeable gown  during the procedure. 

amal photo.JPG

3. Use a Latex free rubber dam and Nitrile gloves for dentist and assistant

4. Use a high-volume suction aspirator over the rubber dam and a low suction aspirator under the rubber dam during the removal

5.  Cut the amalgam into chunks and keep the fillings cool during removal

6. Use air vacuum during the removal

7. Air purifier and ionizer in the office good for 3000 sq ft 

8. Remove gloves and clean the patient’s mouth

9. Immediately clean up

10.Disinfection with laser

11. Apply ozone gas over the tooth before the appropriate restoration is placed

ama 2.jpg

Once the amalgam is remove we restore the tooth with a BPA and Flouride free composite recommend by the IAOMT. Read about the composite we use                         

You can see in the pictures  the attire that we use for us and for the patient. The oxygen mask is transparent. We protect us and our patients.

Office Handout About SMART

BPA Free Composites and Sealants

BPA Free composites

WHAT IS WHITE COMPOSITE FILLING?

A composite is a mercury free filling (tooth colored) that is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth is removed and then filled with a composite filling. I use a BPA and fluoride free composite. We are a free mercury practice.

Click to view the composite material we use.

HOW ARE COMPOSITE FILLINGS PLACED?

We only place composite fillings. There are many options and we determine which is the most compatible with our patients before we place them. Composite fillings can usually be placed in one appointment. While the tooth is numb, we remove decay as necessary. The space is then thoroughly cleaned and carefully prepared, and ozone gas is given before the new filling is placed. If the decay is near the nerve of the tooth, a special medication will be applied for added protection. The composite filling is then precisely placed, shaped, and polished, restoring your tooth to its original shape and function.

It is normal to experience sensitivity to hot and cold when composite fillings are placed. This subsides shortly after your tooth acclimates to the new filling. You will be given care instructions at the conclusion of your treatment. Good oral hygiene practices, eating habits, and regular dental visits will aid in the life of your new fillings.

 

Bio Compatibility Test for Materials

What is the  Materials Sensitivity and Reactivity Test?

We offer bio compatibility tests to patients that have a lot of environmental sensitivities or have reacted negatively to certain dental materials in the past.  We offer both Clifford and Biocomp lab . These laboratories' screening processes help to identify existing sensitivity problems to various chemical groups and families of compounds in an individual.  After the test has been completed, your reactivity results are compiled in a report.  

In modern society, contact is made every day with many substances in the food you eat, the products you use, and the treatments you receive. Because everyone possesses a unique biochemistry, these substances affect everyone differently and to varying degrees. For some, the effects of certain substances (and their corrosion byproducts) can be toxic and hazardous, and may result in serious health problems. A substance which causes little or no reaction in one individual can prove harmful to another.

Since these effects vary, it is vital that these factors be considered when choosing dental and other materials for use in your body, especially when you have special or unique health concerns. These tests provide Dr. Burke with extensive information about your individual sensitivities so that she can choose the best materials to use in your treatment.

How do I order the test?

Dr. Burke can make the kits readily available to anyone wishing to identify any existing sensitivity problems. However, Dr. Burke does not have the capabilities to perform testing in his office. The kits can be self ordered at the http://www.biocomplabs.com/ and http://www.ccrlab.com/

CBCT (cone beam computed tomography) and Digital X-rays

IMG_9521.jpg

 

CBCT (cone beam computed tomography)

 At Family Holistic Dentistry, we have a Planmeca Romexis imaging device for digital panoramic and cone beam 3D imaging. The Planmeca Ultra Low Dose x-ray establishes that the low dose imaging protocol enables CBCT (cone beam computed tomography) imaging with a significantly lower dose than standard imaging without a statistical reduction in image quality. Patients benefit from improved 3D diagnostics without being exposed to a high radiation dose. Dr Carmen Burke gets the better technology to be sure her patients have less radiation exposure and don't have to go to another office to get a CBCT. We can take the image here at our office for you.

If you have any suggestions that can help us make the experience more comfortable for you, please feel free to tell us.

IMG_9541.jpg

Digital X-rays

We take x- rays when necessary. Each patient is treated in an individual manner.  If you have recently had x-rays taken, please bring them with you.  We will evaluate if they are clear enough to do a good diagnosis. If not we can take them here in order to have an accurate reading.

The advantages digital x-rays have over traditional photographic film include time and efficiency through bypassing chemical processing and the ability to digitally transfer and enhance images. In addition, less radiation is used to produce an image of similar contrast to conventional radiography.

Instead of x-ray film, digital radiography uses a digital image capture device. The advantages of this device are many, including immediate image preview and availability and a wider dynamic range. A wider dynamic range is more forgiving with over-and under-exposure, and it also allows the application of special image processing techniques that enhance the overall display quality of the image.

We  carry an intraoral Dexis sensor to ensure the experience is comfortable for all patients. The Dexis sensor is the latest available on the market, is smaller than film x-rays and other digital sensors, and has curved edges for the patient’s comfort. If you have a small mouth, don’t worry, this sensor will fit and be more comfortable than many that you have previously used . We can use  our Planmeca imaging device  to take bite-wings or a panoramic image when is needed. 

If we need to take an x-ray for a child, we use our Dexis digital sensor, as it is more comfortable for little ones and helps to give him/her a better experience at our dental office.

 

Learn more about the Planmeca Ultra Low Does x ray here.

 

 

Planmec.jpg

Extractions with Ozone, Laser and PRF

Extraction with Ozone,Laser and PRF

Platelet-rich fibrin (PRF) is a process whereby blood is drawn and spun in a centrifuge, which separates out portions of the blood into including platelets (which stop bleeding), white blood cells (which fight infection) and growth factor (which promote healing), among others. These cells are then injected directly into affected areas of the mouth to promote faster healing and to increase blood flow to these areas. The PFR is derived from your own blood, so biocompatibility is guaranteed. No gelling agents are needed, and no synthetic or animal derived products are used. It is a well tested replacement for the “non-native” materials such as bovine or coral. It is 100% natural to the patient.

IMG_9582.jpg

Some dental uses of the PRF process include treatment of:

  • Bone Defects
  • Extraction Sockets
  • Sinus and Dental Ridge Augmentation
  • Palatal Defects
  • Maxillary Bone Atrophy

Benefits of PRF Treatment in Tooth Extraction Sites:

  • Faster Bone Healing
  • Less Pain after Tooth Extractions
  • Decreased Swelling During Healing
  • Decreased Chance of Dry Socket and Bone Infection
  • Increased early blood supply to Tooth Extraction Socket

The most common post-extraction complications are pain, discomfort, swelling and development of dry socket. Dry socket develops when the blood clot in a healing tooth extraction site dislodges from the tooth extraction socket soon after extraction of teeth. Clot displacement is associated with lysis of fibrin and delayed wound healing. The Laser and  PRF with ozone reduces the chance of dry sockets and can decrease discomfort and promote healing. I often recommend PRF with dental surgeries to achieve optimal healing.

Some scientific literature on PRF: 

Influence of Leukocyte- and Platelet-Rich Fibrin (L-PRF) in the Healing of Simple Postextraction Sockets: A Split-Mouth Study

Clinical effects of platelet-rich fibrin (PRF) following surgical extraction of lower third molar

Efficacy of platelet rich fibrin in the reduction of the pain and swelling after impacted third molar surgery: Randomized multicenter split-mouth clinical trial

Role of Platelet rich fibrin in wound healing: A critical review

IMG_9474.jpg

BPA Free Mouth Guard and Orthotic

 At Family Holistic Dentistry we do custom Night Guards and Orthotic devices without BPA. 

 A Night Guard is a protective device for the mouth that covers the teeth and gums to prevent and reduce injury to the teeth, TMJ,arches, lips and gums.  A mouth guard is most often used to prevent injury in contact sports, as a treatment for Bruxism (grinding/clenching), or as part of certain dental procedures. Grinding can injure teeth, as it can cause fractures and  local pain in the mouth or jaw, and may contribute to Temporomandibular Joint Syndrome (TMJ).  Having a mouth guard helps prevent major issues such as fractures and root canals, among others.

The Orthotic, on the other hand, places the teeth in a position where the jaw muscles and the TMJ are comfortable and relaxed.

An Orthotic is designed to stop grinding and, therefore, many symptoms associated with TMJ are decreased or go away altogether. While some think the only symptoms of the condition are popping in the jaw and jaw pain, it may manifest in various ways, including keeping you from getting a good night’s sleep, ringing in your ears (tinnitus),feeling your ears full ,chronic headaches or migraines are also commonly misdiagnosed symptoms.

If you suspect that you are grinding , have unexpected fillings or teeth fractures, symptoms in your ears , etc, come and talk to us for an evaluation. We help patients find their perfect fit.  

Call us today at (303) 219-0499 to make an appointment. 


 

Root Canal Treatments (RCT) with Laser, SWEEPS Photoacoustic Endodontics

Root Canal Treatment (RCT)

As a Holistic/Biological dentist I am so happy that I found a more holistic approach on how to perform a root canal for those who don't want to loose their teeth. Fotona Laser Lightwalker offers a better way to disinfect the canals removing the biofilm from even the minuscules accessory canals present in the teeth.

A lot of people ask me what my thoughts are on root canal treatment.  I have done many root canal treatments in my career and I continue to do so even though there is controversy from some quarters on the practice. The origin of the controversy lies in the question of remnant populations of microbes in the dentinal tubules in root canal treated teeth and whether or not endodontic techniques adequately disinfect them or keep them disinfected.

The American Dental Association position on RCT is: "The effectiveness of root canal treatment is well-established. However, misinformation continues to circulate on the Internet that may cause patients to question the safety of endodontics." The IAOMT position is more nuanced, and asks  whether alternative materials and techniques can yield a more biologically acceptable outcome for those that wish to keep their teeth through RCT.  Either way, it is important for a dentist to provide informed consent about the benefits and risks of RCT.

I work  with each patient  to find the right treatment for him/her and always start with the question: "How important is for you to keep that tooth?"  I ask  that question because each individual has different values. Decisions will affect people's emotions, and emotions affect people’s health.

When  the nerve of a tooth is damaged, there are only two options: RCT or Extraction. An extraction is an amputation, the person can be affected emotionally if for them it is important to keep their teeth. On the other hand, there are some people that don’t would rather have the tooth  extracted and replaced with a bridge, removable or an implant.  I educate my patients about both procedures and their pros and cons and then let them choose the best treatment for their needs.

What is a root canal?

The root canal is a natural chamber inside of the tooth that houses the dental pulp, which is known as the tooth nerve.  The pulp is responsible for nourishing the tooth and transmitting pain and sensitivity signals to the brain.

When do you need a RCT?

  • Deep dental decay exists near the pulp or pulp is exposed.
  • Traumatic tooth injuries have created fractures or cracks and compromised the root canal.
  • The pulp or nerve is infected. 
  • Previous dental work, such as deep fillings, have created irritation.

Once the nerve is irreversibly damaged and you want to save the tooth, a RCT should be performed.  There are different ways to clean the canal and different options on which material  to use to fill the cleaned canal.

What does root canal therapy involve at our office?

  1. A root canal procedure requires at least two appointments to be sure that the infection is fought properly.  
  2. We are sure our patient is comfortable and with low stress without  neither medications nor Nitrous Oxide,  we recommend some homeopathic remedies  and BLAST technology using  TouchPoints instead. 
  3. We apply local anesthesia( either with or without epinephrine based on your needs), we have some simple distraction technique that helps to achieve painless anesthesia improving the comfort. 
  4. A Non latex rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva.
  5. If tooth decay is present, it will be removed with burs and dental instruments.
  6. An access opening is made on top of the tooth, and if you have a zirconia or  a porcelain crown I can remove with my laser  and be able to cement it again. If you have a PFM( porcelain fused to metal )crown, I can do the access  on the top through it, We can keep the crown if no recurrent decay is present.  
  7. Series of hand and rotary  files are placed into the canal to shape it and clean it  with constant irrigation.
  8. Then irrigation and disinfection is done with  ozone therapy  and  using  SWEEPS Photoacoustic Endodontics and laser  which Improves debridement and disinfection in the main and  accessory canals  and it is More patient friendly( No heat involved).
  9.  Canals are dried.  Once the tooth is thoroughly cleaned, it will be sealed temporarily with Calcium hydroxide (an alkaline material), and a temporary filling will be placed.

At the next appointment, usually a week later, calcium hydroxide is rinsed. The roots are filled and sealed .  A temporary filling is then placed to cover the opening on top of the tooth.  One week later, if there is not evidence of  infection, either a  Bioclear   composite restoration or a  one day crown (cap)  will be  placed.  This will protect the tooth and prevent it from breaking, and restore it to its full function.  After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed.  Many times the patient will need to take antibiotics  and analgesics. You will be given care instructions after each appointment. Good oral hygiene and regular dental visits will aid in the life of your root canal treatment. 

Complications. There are many things which can compromise the result, including:

  • Resistant bacteria
  • Unknown factors, that nobody can explain
  • Fracture in the root
  • Microscopic accessory canals impossible to reach or clean
  • A broken instrument lodged in the root canal (a rare occurrence) 

Further treatment could be necessary which means repeating the process of cleaning and filling the root, or it can involve surgery to treat the ends of the roots directly (Apicoectomy). On rare occasions, the tooth must be extracted.

If you decide to have a root canal at my office, I will explain the procedure in detail. If you want to have the root canal with a specialist, I would be more than happy to refer you.

 Learning  how to perform a  root canal with a Holistic approach from Dr Valery Kanter  https://drvaleriekanter.com/laser-dentistry

Learning  how to perform a  root canal with a Holistic approach from Dr Valery Kanter https://drvaleriekanter.com/laser-dentistry

Same day Crowns, Partial Crowns, Bridges and Implants Crowns

SAME DAY CROWNS, PARTIAL CROWNS, BRIDGES AND IMPLANT CROWNS

Our office offers the last CEREC technology to offer same day crowns, partial crowns and bridges.

IMG_9618.jpg
IMG_9579.jpg

CEREC uses CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) technology that incorporates a small, hand-held camera and a computer in one instrument, and a milling unit to grind/mill restorations in-house. The camera is used to capture the 2D or 3D image of the affected tooth/teeth and the surrounding area. This image is then displayed on a computer screen where the dentist then uses the special CEREC Software to create the perfect restorative tooth/teeth. Once the virtual restoration is created, the information is then sent to the milling unit via software and milled onsite within 8-10 minutes.When you have a tooth or teeth that are missing some structure due to fractures, decay or grinding wear, or you lost a tooth, you can strengthen them with crowns or replace them with implants or bridges.

A crown is for an individual tooth. A bridge is done to replace 1 missing tooth using two adjacent teeth as a support.  An implant replaces one tooth without compromising its adjacent teeth.

A crown ("cap") is a covering placed over a tooth. Crowns serve many functions, such as strengthening, restoring and improving the appearance of your tooth. A crown covers the tooth when there is no longer sufficient structure left to place a filling. Crowns may also be used to protect the structure of a tooth that is fractured or broken, and can be attached to bridges or dentures.

Crowns and bridges can be made of porcelain, metal or porcelain fused to metal. I recommend all porcelain crowns and bridges since we are a free mercury and metal free dental office. Dental porcelain can be sculpted to closely replicate the look of natural tooth enamel, while providing desirable strength and resilience. They are more biocompatible and there is no need for metals in your mouth.

Partial crowns, often referred to as on-lays, are a type of restoration or filling that covers one or more cusps. An inlay is similar to a filling but the work resides completely within the cusps on a tooth’s chewing surface. These restorations are much more conservative than crowns, and can be imperceptible from your natural tooth.  These "partial crowns" can be done the same day using our in office technology.

If you don’t want to involve adjacent teeth, you can choose an implant.  An implant is a type of screw which is placed inside of your bone and a crown is placed later. If you want to have an implant, I will be happy to refer you to a specialist to complete the surgical part, and then months later, once your implant is oseo-integrated, I will do the definitive crown for you.

 

IMG_9644.jpg

Removable Partial and Complete Dentures

Dentures , Partial Dentures and Flippers

When people lose their teeth, it is better to replace them to have muscle, TMJ, and occlusion support. They could be replace with fixed or removable appliances.

Removable Appliances:

A denture is a removable dental appliance and a replacement for missing teeth and surrounding tissue. They are designed to closely resemble your natural tooth and even enhance your smile. There are three types of dentures: 1) Complete: used when all of the teeth are missing. 2) Partial: used when some natural teeth remain. A Partial denture not only fills in the spaces created by missing teeth, but it also prevents other teeth from shifting. 3) Flipper: used when one or two teeth are missing.

Complete Dentures:

A complete denture can be either “conventional” or “immediate.”  A conventional type is made after the teeth have been removed and the gum tissue has healed, which usually takes 6 to 8 weeks. During this time, the patient will go without teeth. Immediate dentures are made in advance and immediately placed after the teeth are removed, thus preventing the patient from having to be without teeth during the healing process. Once the tissues shrink and heal, adjustments will have to be made.

Dentures are very durable appliances and will last many years but may have to be remade, repaired, or readjusted due to normal wear. The process of getting dentures requires several appointments, usually over a period of several weeks. Highly accurate impressions (molds) and measurements are taken and used to create your custom denture.  Several “try-in” appointments may be necessary to ensure proper shape, color, and fit. At the final appointment, your dentist will precisely adjust and place the completed denture, ensuring a natural and comfortable fit.

It is normal to experience increased saliva flow, some soreness, and possible speech and chewing difficulty, however, this will subside as your muscles and tissues get used to the new dentures. You will be given care instructions for your new dentures.

Partial Dentures:

Partial Dentures involve impressions for both arches, bite, registration, color, and shade selection. The time that a patient should wait after the extraction to fabricate the partial may vary depending on the number of the teeth missing.

Flipper:

Flipper Dentures involve impressions for both arches, color, shade selection. Sometimes the bite registration can be hand articulated when the occlusion is stable and there are teeth on each side of the missing tooth.

Each case is unique and needs to be evaluated.  If you need to replace your missing tooth/teeth and decide to go with a removable appliance, I will explain the procedure in detail to you.

Second Opinions

Second Opinions

Our office is able to provide second opinions on a variety of dental issues.  Last year alone I kept four young children from going under recommended  general anesthesia for extensive cavities by using ozone trays and parental education to buy time.

OralDNA Labs


At our office, we use clinical laboratory services from OralDNA Labs® to ensure we are giving our patients the best oral health information possible. OralDNA Labs® is a specialty diagnostics company designed to provide reliable, definitive and cost effective clinical tests that guide oral health professionals in detecting and prognosing disease at an earlier, more treatable stage.

A lot of times I find abundant bleeding in patients that have good oral hygiene and good nutrition. The cause could be a  bacteria ,virus, fungus or parasites. There is a kind of bacteria that is resistant to cleaning. When this is the case, we should use other ways to eradicate those microorganisms.  

Oral DNA test gives me the opportunity to know exactly which type of microorganism is causing that either bleeding or  pockets or discomfort and at the same time chose the best treatment to eradicate those  or at least to have them in a low level.

 

The test is very simple and takes just few minutes at our office:

1- We give you saline to switch in your mouth for 30 seconds

2-You spit it out in a container with a preservative

3-we pack and label it  up with with your information

4-We send it to the Oral DNA lab  and they send us the report of the results in a short time by email.

5-Once we received the results, we discuss the recommended treatment  and find the best fit for you.

6- If bad bacteria is found, you start the treatment and we retest 8 weeks after the treatment is implemented.