Caring Dentistry of San Rafael also offers these services
  • The term dental bone graft refers to a procedure to regrow bone in someone's mouth. Usually it's done when there isn't enough bone to place dental implants, but sometimes we do it to repair bone damage from periodontal disease (gum disease). In the not so distant past, patients without adequate bone were simply told they couldn't have implants. Bone grafting plays a very important role in making new teeth possible. It is a surgical procedure, but we have been doing this a long time and we have ways of making it as easy as possible.

  • Cosmetic Dentistry

      Composite Fillings

      A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling.

      There are many types of filling materials available, each with their own advantages and disadvantages. You and your dentist can discuss the best options for restoring your teeth. Composite fillings, tooth colored restorations, are the most widely used today. Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more aesthetically suited for use in front teeth or the more visible areas of the teeth. Traditional silver fillings are still around.  A recent study showed silver fillings, also called mercury fillings or amalgam fillings, last longer than composites. Since no *scientific study has every shown any harm associated with these fillings, they remain an option. * Scientific studies are considered research published in professional journals and peer reviewed, there are many opinions about silver fillings, but no scientific studies show associated pathology.

      As with most dental restorations, composite fillings are not permanent and may someday have to be replaced. They are durable, and will last many years. Silver fillings have an even longer lifetime and may be considered for less esthetic areas, or for patients with rampant caries.

      Reasons for composite fillings:
    • Chipped teeth.
    • Closing space between two teeth.
    • Cracked or broken teeth.
    • Decayed teeth.
    • Worn teeth.


    • Reasons for silver fillings:

    • Patients looking for fillings that will last the longest
    • Patients with a very high cavity risk
    • For fillings in areas of the tooth that are under the gum.
    • Other select uses


    • How are composite or amalgam fillings placed?

      Fillings are usually placed in one appointment. While the tooth is numb, your dentist will remove decay as necessary. The space will then be thoroughly cleaned and carefully prepared before the new filling is placed. If the decay was near the nerve of the tooth, a special medication will be applied for added protection. The composite filling will then be 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 first placed, however this will subside 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.

      Porcelain Crowns (Caps)

      A crown (or cap) is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens tooth structure that cannot be restored with fillings or other types of restorations.

      Although there are several types of crowns, porcelain (tooth colored crown) are the most popular, because they resemble your natural teeth. They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced. Porcelain crowns are made to match the shape, size, and color or your teeth giving you a natural, long-lasting beautiful smile.

      Reasons for crowns:

    • Broken or fractured teeth.
    • Cosmetic enhancement.
    • Decayed teeth.
    • Fractured fillings.
    • Large fillings.
    • Tooth has a root canal.


    • What does getting a crown involve?

      A crown procedure usually requires two appointments. Your first appointment will include taking several highly accurate molds (or impressions) that will be used to create your custom crown. A mold will also be used to create a temporary crown which will stay on your tooth for approximately two weeks until your new crown is fabricated by a dental laboratory. While the tooth is numb, the dentist will prepare the tooth by removing any decay and shaping the surface to properly fit the crown. Once these details are accomplished, your temporary crown will be placed with temporary cement and your bite will be checked to ensure you are biting properly. At your second appointment your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite are accurate. You will be given care instructions and encouraged to have regular dental visits to check your new crown.

      Porcelain Fixed Bridges

      A dental bridge is a fixed (non-removable) appliance. Bridges used to be the standard treatment for many missing teeth situations. Dental implants (artificial tooth roots) have become the more common way to replace missing teeth, but there are still times when bridges are used. Bridges consists to two crowns that go over two anchoring teeth (abutment teeth) and are attached to pontics (artificial teeth), filling the gap created by one or more missing teeth. Because the natural teeth adjacent to the missing teeth have to be altered and because the bone in the area of the missing teeth will slowly melt away bridges have become the second choice for most patients. Medical problems may render implant treatment unadvisable. Bridges are a good stable alternative for these patients. Dental bridges are durable and will last many years, however they may need replacement or need to be re-cemented due to normal wear.

      Reasons for a fixed bridge:

    • Fill space of missing teeth.
    • Prevent remaining teeth from drifting out of position.
    • Restore chewing and speaking ability.
    • Restore your smile.
    • Upgrade from a removable partial denture to a permanent dental appliance.


    • What does getting a fixed bridge involve?

      Getting a bridge usually requires two or more visits. While the teeth are numb, the two anchoring teeth are prepared by removing a portion of enamel to allow for a crown. Next, a highly accurate impression (mold) is made which will be sent to a dental laboratory where the bridge will be fabricated. In addition, a temporary bridge will be made and worn for several weeks until your next appointment. At the second visit, you permanent bridge will be carefully checked, adjusted, and cemented to achieve a proper fit. Occasionally your dentist may only temporarily cement the bridge, allowing your teeth and tissue time to get used to the new bridge. The new bridge will be permanently cemented at a later time. You will receive care instructions at the conclusion of your treatment. Proper brushing, flossing and regular dental visits will aid in the life of your new permanent bridge.

      Porcelain Veneers

      Veneers are very thin pieces of durable, tooth shaped porcelain that are custom made (for shape and color) by a professional dental laboratory. They are bonded onto the front of teeth to create a beautiful and attractive smile.

      Veneers can completely reshape your teeth and smile. They can often be alternatives to crowns and the ideal solution in treating many dental conditions.

      As with most dental restorations, veneers are not permanent and may someday need replacement. They are very durable and will last many years, giving you a beautiful long lasting smile.

      Reasons for porcelain veneers:

    • Cosmetically, to create a uniform, white, beautiful smile.
    • Crooked teeth.
    • Misshapen teeth.
    • Severely discolored or stained teeth.
    • Teeth that are too small or large.
    • Unwanted or uneven spaces.
    • Worn or chipped teeth.
    • What does getting porcelain veneers involve?

      Getting veneers usually requires two visits to complete the process, with little or no anesthesia required during the procedure.

      The teeth are prepared by lightly buffing and shaping the surface to allow for the thickness of the veneer. A mold or impression of the teeth is taken and a shade (color) will then be chosen by you and the dentist. On the second visit the teeth will be cleansed with special liquids to achieve a durable bond. Bonding cement is then placed between the tooth and veneer and a special light beam is used to harden and set the bond.

      You will receive care instructions for veneers. Proper brushing, flossing and regular dental visits will aid in the life of your new veneers.

      Tooth Whitening

      Tooth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel and is an ideal way to enhance the beauty of your smile. Because having whiter teeth has now become the number one aesthetic concern of most patients, there are a number of ways to whiten teeth. The most popular method is using a home tooth whitening system that will whiten teeth dramatically. Since tooth whitening only works on natural tooth enamel, it is important to evaluate replacement of any old fillings, crowns, etc. Replacement of any restorations will be done after bleaching so they will match the newly bleached teeth. Tooth whitening is not permanent. A touch-up maybe needed every several years, and more often if you smoke, drink coffee, tea, or wine.

      Reasons for tooth whitening:
    • Fluorosis (excessive fluoridation during tooth development).
    • Normal wear of outer tooth layer.
    • Stained teeth due to medications (tetracycline, etc.).
    • Yellow, brown stained teeth.


    • What does tooth whitening involve?

      This type of tooth whitening usually requires two visits.

      At the first appointment, impressions (molds) will be made of your teeth to fabricate custom, clear plastic, trays. At your second appointment, you will try on the trays for proper fit, and adjustments will be made if necessary. The trays are worn with special whitening solution either twice a day for 30 minutes or overnight for a couple of weeks depending on the degree of staining and desired level of whitening. It is normal to experience tooth sensitivity during the time you are whitening your teeth, but it will subside shortly after you have stopped bleaching. You will receive care instructions for your teeth and trays, and be encouraged to visit your dentist regularly to help maintain a beautiful, healthy, white smile.
  • Crown Lengthening Procedure

    Crown lengthening is a procedure used to expose more tooth structure. When tooth decay gets large and goes below the gum line sometimes this is the only way to save the tooth.

  • Dental Crowns
      A crown, also called a cap, covers the entire tooth surface to restore it to its original shape and size. If a tooth is cracked, broken or if a filling isn't strong enough to restore a tooth a crown is used to protect and strengthen the tooth structure. While there are several types of crowns to choose from, porcelain crowns are the most popular as they most closely resemble your natural teeth in size, shape and color. Porcelain is highly durable and will last many years.

      Reasons for crowns:

    • Broken, Cracked or Fractured Teeth
    • Cosmetic Enhancement
    • Decayed Teeth
    • Fractured Fillings
    • Large Fillings
    • Tooth has a Root Canal
  • Dental Exams
      A comprehensive dental exam will be performed at your initial dental visit and at each subsequent visit. Regular exams are important to your dental as well as your overall health. Certain diseases may start or be seen first in the mouth. Dental exams are a part of early detection.

      At regular check-up exams, your dentist and hygienist will include the following:

    • Examination of diagnostic digital x-rays - Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
    • Oral cancer screening - Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
    • Gum disease evaluation - Check the gums and bone around the teeth for any signs of periodontal disease.
    • Examination of tooth decay - All tooth surfaces will be checked for decay with special dental instruments.
    • Examination of existing restorations - Check current fillings, crowns, etc.
  • Dental Implants
      Dental implants are generally the first choice to replace missing teeth. A bridge used to be the most common way of dealing with a missing tooth.  The downside is that the adjacent teeth need to be altered with the drill to make a bridge.  Another option to replace missing teeth is to make an appliance that is removable (meaning you take it out at night). There are several reasons why many patients avoid removable appliances; sore spots on the gums, sometimes they don’t stay in too well, problems speaking  and eating and more. The up side is that removable dentures are relatively inexpensive.

      Dental implants are artificial roots and teeth (usually titanium) that are gently  placed into the upper or lower jaw. Some patients choose to use oral sedation when we place the implants, although many don’t need it.  Teeth are attached to the implants (artificial tooth roots) and generally are quite stable for many years. Though they are strong and durable, on occasion they will have to be re-tightened or replaced due to normal wear.

      Reasons for dental implants:

    • Replace one or more missing teeth without affecting adjacent teeth.
    • Retain jaw bone that supports our facial features.
    • Restore a patient's confident smile.
    • Restore chewing, speech, and digestion.
    • Restore or enhance facial tissues.
    • Support a bridge or denture, making them more secure and comfortable.


    • What does getting dental implants involve? We use the latest technology to make this treatment faster and more predictable. Our 3-D x-ray machine allows us to plan your treatment thoroughly before your appointment so there are no surprises. Many patients choose to use sedating medication, and report the appointment like a distant memory.

      The timeline of treatment varies considerably from case to case and Dr. Miller will discuss the particulars of your case with you. Remember you can have a free consultation with Dr. Miller to see what your best options are.

  • Dental X-Rays
      Dental radiographs (x-rays) are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam. At Caring Dentistry we not only have digital x-rays, which reduce radiation exposure, but we also have three dimensional x-rays. To maintain "standard of care" every five years dental offices take a full mouth x-ray series (FMX) of each patient. This series is taken to thoroughly examine the entire oral cavity, including the roots of the teeth and the bones of the jaw. With 3-D technology we can do this more effectively than ever before. A three dimensional x-ray is like holding a rose in your hand, turning it to see every detail, as opposed to a two dimensional x-ray which is like looking at a painting of a rose. We use the information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan. Without x-rays, problem areas may go undetected or small problems left to fester requiring more extensive treatment later.

      Dental x-rays may reveal:
    • Abscesses or cysts.
    • Bone loss.
    • Cancerous and non-cancerous tumors.
    • Decay between the teeth.
    • Developmental abnormalities.
    • Poor tooth and root positions.
    • Problems inside a tooth or below the gum line.
    • Detecting and treating dental problems at an early stage can save you time, money, unnecessary discomfort, and your teeth!


    • Are dental x-rays safe?

      We are all exposed to natural radiation in our environment. Our new technology reduces radiation exposure dramatically. Our complete x-ray series (FMX & 3-D) is equivalent to the amount of radiation a person receives naturally from the environment in about twenty eight days. We only take a full mouth series every five to seven years.

      Dental x-rays produce a low level of radiation and are considered safe. Dentists take necessary precautions to limit the patient's exposure to radiation when taking dental x-rays. These precautions include using lead apron shields to protect the body and using modern, digital and flat panel sensors that significantly cut down the exposure time of each x-ray.

      We use state of the art digital x-rays, which further reduce the exposure by up to 90%.

      How often should dental x-rays be taken?

      The need for dental x-rays depends on each patient's individual dental health needs. Your dentist and dental hygienist will recommend necessary x-rays based on the review of your medical and dental history, dental exam, signs and symptoms, age consideration, and risk for disease.

      A complete x-ray series (FMX & 3-D) is recommended for new patients. A complete series is usually good for five to seven years. Bite-wing x-rays (x-rays of top and bottom teeth biting together) are taken at recall (check-up) visits and are recommended once every 12 to 18 months to detect new dental problems.
  • Dentures and Partial Dentures
      A denture is a removable dental appliance replacement for missing teeth and surrounding tissue. They are made to closely resemble your natural teeth and may even enhance your smile.

      There are two types of dentures - complete and partial dentures.

      Complete dentures are used when all of the teeth are missing, while partial dentures are used when some natural teeth remain.

      A Partial denture not only fills in the spaces created by missing teeth, it prevents other teeth from shifting.

      In most cases we combine implants with dentures. The implants provide considerable stability and allow dentures to be used more like natural teeth. Dentures are very durable appliances and will last many years, but may have to be remade, repaired, or readjusted due to normal wear.

      Reasons for dentures:

    • Complete Denture - Loss of all teeth in an arch.
    • Partial Denture - Loss of several teeth in an arch.
    • Enhancing smile and facial tissues.
    • Improving chewing, speech, and digestion.


    • What does getting dentures involve?

      The process of getting dentures requires several appointments, usually over 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. Proper cleaning of your new dental appliance, good oral hygiene, and regular dental visits will aid in the life of your new dentures.
  • Dry Mouth (Xerostomia)

    Xerostomia is a condition in which reduced salivary flow is noted. The composition of the saliva may also be altered. Medication is the most common cause of xerostomia, but there are several causes including radiation therapy. This lack of saliva can result in increased caries (cavities), oral fungal infections (Candidiasis), altered taste sensation, easily irritated oral tissues, difficulty wearing dentures and more.

  • Elderly/Mature Adult Dentistry

    or geriodontics is the delivery of dental care to older adults involving the diagnosis, prevention, and treatment of problems associated with normal aging and age-related oral diseases.

  • Full Mouth Reconstruction

    Bruxism

    Interestingly teeth actually touch very little during normal activity, including chewing. When teeth are damaged, like in the above photo, we can be sure there are factors outside what is considered "normal". Whether while sleeping or during waking hours grinding and clenching are big factors contributing to tooth damage. We call these parafunctional movements, and most think these are the primary factors causing wear to the teeth.

    Gastroesophageal reflux disease (GERD) is the return of the stomach's contents back up into the esophagus and sometimes into the oral cavity. This acidic erosion can be an important factor as well, and in combination with grinding and or clenching the damaging effects can be catastrophic.

    For most people when their teeth do touch there is a certain amount of built in protection. Ideally when the teeth slide over each other forces are mitigated. When one slides the lower jaw to one side the upper and lower canine teeth touch, preventing the back teeth from engaging. This prevents some of the strongest jaw muscles from engaging, but as the teeth wear, the way they come together changes. As the teeth change they engage in ways that results in the stronger muscles being "turned on" more often. As the grinding and clenching continues the damage accelerates. The damage accelerates because the muscles deliver more force, and the deeper layers of the teeth are softer.

    Full Mouth Reconstruction generally implies that a new protective occlusion will be established and the damaging tooth wear will be controlled. This often involves working on most or all of the teeth in the mouth, hence the term; full mouth reconstruction.

  • Home Care

    A beautiful, healthy smile that lasts a lifetime is our ultimate goal when treating patients. Your personal home care plays an important role in achieving that goal. Your personal home care starts by eating balanced meals, reducing the number of snacks you eat, and correctly using the various dental aids that help control the plaque and bacteria that cause dental disease.

    Tooth brushing

    Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.

    Place the brush at a 45 degree angle to the gums and gently brush using a small, circular motion, ensuring that you always feel the bristles on the gums.

    Brush the outer, inner, and biting surfaces of each tooth. Use the tip of the brush to clean the inside of the front teeth. Brush your tongue to remove bacteria and freshen your breath. Electric toothbrushes are also recommended. They are easy to use and can remove plaque efficiently. Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.

    Flossing

    Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

    Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands. Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion. Curve the floss into a "C" shape around each tooth and under the gumline. Gently move the floss up and down, cleaning the side of each tooth. Floss holders are recommended if you have difficulty using conventional floss.

    Rinsing - It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush. If you are using an over-the-counter product for rinsing, it's a good idea to consult with your dentist or dental hygienist on its appropriateness for you.

    Use other dental aids as recommended by your dentist or dental hygienist: Interdental brushes, rubber tip stimulators, tongue cleaners, irrigation devices, fluoride, medicated rinses, etc., can all play a role in good dental home care.

  • Mercury-Free Dental Fillings
      A composite, or tooth-colored, filling is used to repair a tooth that is affected by decay or is chipped. We can also use them to close ugly spaces between teeth. The decayed or affected portion of the tooth will be removed and then filled with a composite filling. Because composite fillings are tooth-colored, they can be closely matched to the color of existing teeth and are esthetically pleasing when you smile. They are very durable, and will last many years, giving you a long lasting, beautiful smile.

      Reasons for composite fillings:

    • Chipped teeth
    • Decayed teeth
    • Closing space between two teeth
  • Periodontal Diseasee
      What is it?

      The word periodontal means "around the tooth". Periodontal disease attacks the gums and the bone that support the teeth. Plaque is a sticky film of food debris, bacteria, and saliva. If plaque is not removed, it turns into calculus (tartar). When plaque and calculus are not removed, they begin to destroy the gums and bone. Periodontal disease is characterized by red, swollen, and bleeding gums. Four out of five people have periodontal disease and don't know it! Most people are not aware of it because the disease is usually painless in the early stages. Not only is it the number one reason for tooth loss, research suggests that there may be a link between periodontal disease and other diseases such as, stroke, bacterial pneumonia, diabetes, heart disease, and increased risk during pregnancy. Researchers are determining if inflammation and bacteria associated with periodontal disease affects these systemic diseases and conditions. Smoking also increases the risk of periodontal disease. Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

      Signs and symptoms of periodontal disease:

    • Bleeding gums - Gums should never bleed, even when you brush vigorously or use dental floss.
    • Loose teeth - Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
    • New spacing between teeth - Caused by bone loss.
    • Persistent bad breath - Caused by bacteria in the mouth.
    • Pus around the teeth and gums - Sign that there is an infection present.
    • Receding gums - Loss of gum around a tooth.
    • Red and puffy gums - Gums should never be red or swollen.
    • Tenderness or Discomfort - Plaque, calculus, and bacteria irritate the gums and teeth.


    • Diagnosis

      Periodontal disease is diagnosed by your dentist or during a periodontal examination. This type of exam should always be part of your regular dental care. A periodontal probe (small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums. The depth of a healthy sulcus measures three millimeters or less and does not bleed. The periodontal probe helps indicate if pockets are deeper than three millimeters. As periodontal disease progresses, the pockets usually get deeper.

      Your dentist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:

      Gingivitis

      Gingivitis is the first stage of periodontal disease. Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.

      Periodontitis

      Plaque hardens into calculus (tartar). As calculus and plaque continue to build up, the gums begin to recede from the teeth. Deeper pockets form between the gums and teeth and become filled with bacteria and pus. The gums become very irritated, inflamed, and bleed easily.Slight to moderate bone loss may be present.

      Advanced Periodontitis

      The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed. Unless treated, the affected teeth will become very loose and may be lost. Generalized moderate to severe bone loss may be present.

      Treatment

      Periodontal treatment methods depend upon the type and severity of the disease. Your dentist will evaluate for periodontal disease and recommend the appropriate treatment.

      Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues. When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth!

      If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings will be recommended. You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.

      If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planning (deep cleaning) will be recommended. It is usually done one quadrant of the mouth at a time while the area is numb. In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planning). This procedure helps gum tissue to heal and pockets to shrink. Medications, special medicated mouth rinses, and an electric tooth brush may be recommended to help control infection and healing.

      If the pockets do not heal after scaling and root planning, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean. We do everything we can to avoid surgical treatment. Your motivation and willingness to change your diet and hygiene behavior is a key to successful therapy.

      Maintenance

      It only takes twenty four hours for plaque that is not removed from your teeth to turn into calculus (tartar)! Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention. Once your periodontal treatment has been completed, your dentist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year. At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy. Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line.

      In addition to your periodontal cleaning and evaluation, your appointment will usually include:

    • Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss.X-rays also help determine tooth and root positions.
    • Examination of existing restorations: Check current fillings, crowns, etc.
    • Examination of tooth decay: Check all tooth surfaces for decay.
    • Oral cancer screening: Check the face, neck, lips, tongue, throat, cheek tissues, and gums for any signs of oral cancer.
    • Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)
    • Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.


    • Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!
  • Professional Dental Cleanings
      Professional dental cleanings (dental prophylaxis) are generally performed by Dr. Mehl. Dr. Mehl is a dentist who has dedicated himself to your periodontal (gum) health. Your cleaning appointment will include:
    • Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
    • Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
    • Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.
  • Restorations

      What are they?

      It's great news that the incidence of tooth decay has significantly diminished over the years due to the use of fluorides and an increase in patient awareness. However, teeth are still susceptible to decay, infection, and breakage and sometimes need to be restored back to health. Through improved techniques and modern technology, we are now able to offer more options for restoring a tooth back to its normal shape, appearance and function.

      Should your teeth ever require a restorative treatment, you can rest assured knowing we will always discuss with you the available options, and recommend what we believe to be the most comfortable and least invasive treatment. Providing you with excellent care is our number one priority when creating your beautiful smile.

      Reasons for restorative dentistry:

    • Enhance your smile.
    • Fill in unattractive spaces between teeth.
    • Improve or correct an improper bite.
    • Prevent the loss of a tooth.
    • Relieve dental pain.
    • Repair damaged and decayed teeth.
    • Replace missing teeth.
    • Replace old, unattractive dental treatments.
    • Restore normal eating and chewing.
    • Remember to give your teeth the attention they need today!


    • Composite Fillings

      A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling. There are many types of filling materials available, each with their own advantages and disadvantages. You and your dentist can discuss the best options for restoring your teeth. Composite fillings, along with silver amalgam fillings, are the most widely used today. Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more aesthetically suited for use in front teeth or the more visible areas of the teeth. As with most dental restorations, composite fillings are not permanent and may someday have to be replaced. They are very durable, and will last many years, giving you a long lasting, beautiful smile.

      Reasons for composite fillings:

    • Chipped teeth.
    • Closing space between two teeth.
    • Cracked or broken teeth.
    • Decayed teeth.
    • Worn teeth.
    • How are composite fillings placed?

      Composite fillings are usually placed in one appointment. While the tooth is numb, your dentist will remove decay as necessary. The space will then be thoroughly cleaned and carefully prepared before the new filling is placed. If the decay was near the nerve of the tooth, a special medication will be applied for added protection. The composite filling will then be 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 first placed, however this will subside 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.

      Crowns (Caps)

      A crown (or cap) is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens tooth structure that cannot be restored with fillings or other types of restorations. Although there are several types of crowns, porcelain (tooth colored crown) are the most popular. They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced. Porcelain crowns are made to match the shape, size, and color or your teeth giving you a natural, long-lasting beautiful smile.

      Reasons for crowns:

    • Broken or fractured teeth.
    • Cosmetic enhancement.
    • Decayed teeth.
    • Fractured fillings.
    • Large fillings.
    • Tooth has a root canal.

      What does getting a crown involve?

      A crown procedure usually requires two appointments. Your first appointment will include taking several highly accurate molds (or impressions) that will be used to create your custom crown. A mold will also be used to create a temporary crown which will stay on your tooth for approximately two weeks until your new crown is fabricated by a dental laboratory. While the tooth is numb, the dentist will prepare the tooth by removing any decay and shaping the surface to properly fit the crown.

      Once these details are accomplished, your temporary crown will be placed with temporary cement and your bite will be checked to ensure you are biting properly.

      At your second appointment your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite are accurate. You will be given care instructions and encouraged to have regular dental visits to check your new crown.
  • Root Canal Therapy
      Root canal therapy is needed when the nerve of a tooth is affected by decay or infection. In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed and the resulting space is filled with special, medicated, dental materials, which restore the tooth to its full function. Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed.

      To understand a root canal it helps to understand the following: The tooth can be thought of as having three "layers". The outermost layer is the white part of the tooth one sees in the mouth. The second layer is a yellow layer about 2 mm below the first. The third "layer" can be thought of as a hollow center. It's not really hollow but filled with blood vessels, lymphatic tissue, the tooth nerve etcetera. When a tooth is irritated, from a cavity or maybe trauma, the soft tissues start to become inflamed. The soft tissues want to welt up like a scratch on one's arm might. The problem is that the tissues can't swell up because they are surrounded by hard tooth structure. Now, since the tissues can't swell, pressure is created. The pressure pushes on the nerves which can cause pain, it also prevents adequate blood flow which will cause the tooth to die. This is when a tooth needs a root canal.

      Okay, so finally to the root canal. A root canal is when we go in and remove all the soft tissue from inside the tooth. Once we have the inner chamber cleaned out, we fill it in with a special filling material that "seals" it off. Now that the cause of the infection is gone, we have a very good chance of the tooth calming down and becoming "normal" again.

      Many patients believe that removing a tooth that has problems is the solution, but what is not realized is that extracting (pulling) a tooth will ultimately be more costly and cause significant problems for adjacent teeth. Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.

      Signs and symptoms for possible root canal therapy:

    • An abscess (or pimple) on the gums.
    • Sensitivity to hot and cold.
    • Severe toothache pain.
    • Sometimes no symptoms are present.
    • Swellingand/or tenderness.


    • Reasons for root canal therapy:

    • Decay has reached the tooth pulp (the living tissue inside the tooth).
    • Infection or abscess have developed inside the tooth or at the root tip.
    • Injury or trauma to the tooth.


    • What does root canal therapy involve?

      A root canal procedure requires one or more appointments.

      While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva. An access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria. If tooth decay is present, it will also be removed with special dental instruments.

      Once the tooth is thoroughly cleaned, it will be sealed with either a permanent filling or, if additional appointments are needed, a temporary filling will be placed.

      At the next appointment, usually a week later, the roots and the inside cavity of the tooth will be filled and sealed with special dental materials. A filling will be placed to cover the opening on top of the tooth. In addition, all teeth that have root canal treatment should have a crown (cap) 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.

      You will be given care instructions after each appointment. Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.
  • Sedation

    There are some things in life we want to remember, dental treatment usually isn't one of them. We generally recommend Oral Conscious Sedation (OCS) for most patients who will have dental treatment lasting 3 hours or longer. Sometimes called "Sleep Dentistry", we have found that it makes long appointments, like those for TeethOnSameDay, easier for both the patient and our team. Dr. Miller and our outstanding staff will do everything to insure that you have a comfortable experience in the office.

    There are 2 oral medications we most often utilize; Triazolam and Lorazepam. Both are from the Benzodiazepine family. These medications are extremely safe and generally very effective. Most patients remember little of their appointment, which is great, who wants to remember a long dental appointment. For some patients we combine Nitrous Oxide (Laughing Gas) with the oral medication.

    You will need a responsible adult to take you to and from your appointment and to stay with you after. We will give you all your "paper-work" before hand, including your informed consent and your post-operative instructions.

    We need an up-to-date medical history and a list of all current medications so we can determine the ideal dosage for you.