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At Ashburn Smile Center, we offer a wide variety of dental services for our patients in Ashburn, Virginia and the surrounding areas. From general to cosmetic dentistry, we will take care of you as if you were our own family. Below you can find a wealth of information about the various services we offer. If you have any questions about our staff or services, please call us directly at 703-726-4444.


Missing teeth are a problem that can have adverse affects on your ability to eat. Dental bridges can be a solution, allowing a person to essentially replace missing teeth. Your existing teeth can be used to create a bridge, filling the space in which a tooth was missing. Bridges can be made from a variety of materials including porcelain, gold or a combination of other alloys. These materials assure stability and remain durable to aid in a long lasting restoration.

In order to create this bridge your existing teeth are prepared to create what’s known as an abutment. Creating an abutment requires recontouring your existing teeth to allow the dentist to create a base for your new tooth. Once the abutments are made, an impression is taken of the area prepared, and this is sent to a dental lab to create your new tooth. The dental lab uses this impression of the area to create a bridge that fits the natural contour of your mouth allowing it to look and feel as close as possible to your natural tooth. This fabricated tooth, known as a pontic, will replace your missing tooth and aid in both cosmetics and function. A bridge in total consists of two abutment teeth on either side of the pontic.

While the dental lab is fabricating your new tooth a temporary bridge is made in the office, that will fit to the abutments used for the bridge. This temporary bridge protects the recountored teeth as well as your gums and will also serve as a temporary replacement to the missing area. Once the dental lab fabricates your custom bridge, a follow up visit is required to permanently place the custom bridge. A strong dental adhesive is used to place the bridge permanently in your mouth.

A new bridge sometimes can require a little bit of time to get used to, however, after a few days patients adjust to the new bridge and function as they would with their natural teeth. After this slight adjustment period you will be able to eat all the foods you love with no issues. Dental bridges are great for people missing a few teeth, and it is important to remember that a dental bridge, like your natural teeth, need to be taken care of including regular brushing and flossing.

A dental bridge is a great option if you are considering replacing a missing tooth. It is important to note that a missing tooth can cause more challenges than just being able to eat. Missing a tooth can cause the remaining teeth to shift, which may lead to increased problems throughout the years. Call our dentists in Ashburn today to make your appointment.

As time goes on our teeth begin to become more prone to problems such as cavities, discoloration, cracks, and fractures. Dental crowns can be a great solution to some of these problems, and can help you get back to your great smile. Dental crowns can be made from a variety of materials and it is usually fabricated from porcelain. Porcelain is a strong material that has the ability to blend with your natural teeth and help keep your natural looking smile. The dentist has the ability to change the shade of porcelain to customize the crown to your natural tooth color. Dental crowns can be used for your front teeth as well, helping to enhance your natural smile.

As teeth become weakened due to a variety of causes, sometimes a filling will not lead to a permanent solution. Other issues such as fractures or cracks in your teeth can compromise the integrity of your tooth to the point where fillings will not give you a permanent solution. Cavities are also another reason for a dental crown. As cavities become bigger it compromises your tooth structure, and if big enough, a cavity must be replaced with a crown. The process of making a crown can take a few visits with the dentist. The initial visit usually involves removing the underlying cause as well as giving a base in which to make the crown. This involves recontouring the enamel of the tooth in question to allow a crown to be placed over the restored area. Once your enamel has been recontoured, an impression of the area is taken which will be sent to the dental lab. Local anesthetic is given during this initial appointment to aid in any discomfort you may have. Before you leave this initial appointment a temporary crown will be placed to help you with cosmetics and chewing.

After this initial visit the impression of the prepared tooth will then be sent to the dental lab. The lab will fabricate a tooth, usually made of porcelain, to match the color of your existing teeth, giving your smile a natural look. The new crown will replicate the contour and shape of your existing teeth as well. This process usually takes a few weeks, during which you will have a temporary crown. Once the dental lab is finished creating your crown, the dentist will seat the crown using a strong dental adhesive. Once the crown is placed, you will see your great smile once again. Crowns must be maintained with proper home care which includes brushing and flossing, just as you would do with your natural teeth. Dental crowns can last for 10-15 years with regular care. Call our Northern Virginia dentists to learn more about crowns and to make an appointment today.

Often times when a person is missing all or some of their teeth a denture can be a great treatment. Dentures are generally classified into two groups known as a complete denture or a partial denture. A complete denture is made when a person is missing all of their teeth. A partial denture is made when a person is missing multiple teeth in a certain area.

When a person is missing all of their teeth a full denture is usually required. A full denture can be categorized into two different types: conventional full denture and an immediate full denture. A conventional denture can also be made using implants to aid in retention of the denture.

Conventional Full Denture – This type of complete denture is used when all of the teeth are removed, and a period is given to allow the gum tissue to heal from extracting the teeth. When teeth are removed it may take up to 2 months, depending on the circumstances, for the gums to heal completely. Once the gums have completely healed an impression is taken of your mouth and this impression is sent to the lab. The dental lab then fabricates a complete denture that is customized to each individual. The dentist will work thoroughly with you to select the correct shade and shape of your new denture teeth that best matches you. A transitional denture can also be given to you while your gums heal so that you do not have to go any period of time without teeth. However a lab made custom denture must be made after the gums heal due to the changing nature of your mouth. Once gums heal the transitional denture will need to be replaced with a complete custom made conventional denture. A conventional denture can also be made using implants to help give the denture extra retention in your mouth.

Immediate Full Denture – This type of complete denture is made prior to removing any teeth. Your dentist will take measurements of your mouth and have the dental lab create a denture that best fits you personally. The main benefit of this type of denture is that you do not have to go any period of time without teeth. This type of denture however requires a follow up visit to refit your denture due to the changing nature of your jaw bone after removing teeth and allowing your gums to heal.

Another type of denture, known as a partial denture, can also be a great treatment if you are missing multiple teeth in a certain area, but are not missing all of your teeth. A partial denture is similar to a dental bridge, however it is not a permanent fixture in your mouth as it can be removed as you desire. A partial denture is made with the assistance of a dental lab to assure proper shape and coloring to match your existing teeth.

Your new permanent denture will require some time to get used to. A denture is something people are not used to as the denture sits over your gums. As you use your new denture you will start to feel as though they are a part of you. Often times when people have adjusted to their denture they say they don’t know how they ever ate or smiled without it! It is important to visit your dentist as needed to refit the denture if need be as sometimes the denture can loosen over time, depending on which type of denture you elected for. Even though dentures aren’t your real teeth they still need to be cared for. They should be removed at night to allow your gums a chance to relax. Dentures also need to be cleaned often to remove plaque. After the dentures have been removed they should be rinsed with room temperature water and placed in denture cleaning solution. Dentures are also somewhat delicate and you should be careful as to not drop your denture. If you notice that the denture does not feel right please make a dental appointment so that a denture can be refit or readjusted as necessary. Please call our Ashburn dentists to learn more about dentures.

Often times a tooth can be deemed not restorable and may need to be taken out. There may be many causes for an extraction that include but are not limited to very large cavities, broken teeth, or fractures that extend down the length of the tooth. If other treatment options are available your dentist will discuss those with you. An extraction is usually a 1 visit appointment during which the dentist will give you local anesthetic to minimize any discomfort associated with removing a tooth.

Extracting a tooth is not limited to a tooth that has problems. Wisdom teeth are routinely removed due to how they protrude from the gums. If a wisdom tooth is coming out at an angle from the gums and is in contact with the tooth in front of it then this is known as an impacted wisdom tooth. If these impacted wisdom teeth are not removed then you may feel pain and it can cause other teeth to shift. If a wisdom tooth has only partially come in through the gums then a flap of gum tissue may persist over the tooth and this is known as an operculum. This piece of gum tissue over the wisdom tooth can cause food and debris to get stuck under the gum, leading to swelling and a subsequent infection and this is known as pericornitis. This swelling often times subsides on its own, however it is often painful and can cause discomfort. These reasons are often why removing wisdom teeth are considered routine. Often times local anesthetic is enough to minimize discomfort, however it can also be necessary to perform general anesthetic in which you will be sedated throughout the entire procedure.

No matter the reason for a dental extraction, there are a few precautions to take when undergoing this procedure. After the surgery you will need to rest. It is generally recommend that a friend or family member drive you home due to the anesthesia. It can be expected for the area where the tooth was removed to have bleeding for a few hours. The dentist will apply gauze before you go home, and this should be changed every few hours if bleeding persists. If bleeding continues for longer than 24 hours you should call our office for re-evaluation of the extraction area. When you get home it is important to rest while propping your head up. The dentist will also prescribe pain medication as needed to help with any discomfort that may follow the procedure. An ice pack may also be used when you get home in order to minimize any swelling. A cleaning solution may also be provided for you if deemed necessary by the dentist.

Night Guards
Mouth GuardTeeth grinding, or bruxism, is a common problem among many people. Some people may grind their teeth consciously while they are awake while others may grind at night without any knowledge of it. Grinding your teeth can cause several problems such as damaging your enamel, which is the outer layer of your tooth. Other problems can include wearing down your teeth, irritating your gums, and jaw pain.

People who grind their teeth should strongly consider wearing a night guard. A night guard is very similar to a mouth guard worn during sporting activities. A night guard provides a barrier between your top teeth and your bottom teeth. All night guards are custom made to work with your specific teeth. The procedure is minimally invasive and generally only requires an impression of your teeth. This impression is then sent to the dental lab, which will fabricate a custom night guard.

A night guard is generally worn every night. Once you are given a night guard it is important to bring it with you to your dental appointments so that the dentist may adjust it as needed. To get more information on night guards and make an appointment with Dr. Nikkhah please call our Ashburn office.

What is TMJ/TMD – Temporomandibular Joint Disorder?
A persons TMJ (Temporomandibular Joint) is the area where your bottom and top jaw meet below your ear, and it is the most complex joint in your body. This area can sometimes get irritated or sore due to a variety of causes and this can lead to a multitude of different symptoms. Some symptoms include headaches, facial pain, sore or broken teeth, clicking or popping in by your ear, and/or limited jaw movement. These are known as TMD, or Temporomandibular Joint Disorders.

Due to the area where your TMJ is located it is involved intricately with multiple bones, muscles, and nerves. This location of your TMJ can cause it to affect many areas of your body anywhere from your head to your arms, neck, and back. Due to this a variety of symptoms may be seen, including but not limited to headaches, back pain, neck pain, and tingling in your arms or shoulders. Snoring, grinding of your teeth, ear infections, and restricted airways are also associated with TMJ disorders.

What Causes TMJ?
Temporomandibular Joint Disorders usually stems from whats called malocclusion. Malocclusion means that the way that you bite your upper and lower teeth together is not ideal, or in other words your upper and lower teeth don’t align right. Overbites and underbites are a form of malocclusion. This can be due to numerous causes such as accidents or trauma to the area. When teeth are not aligned right they do not provide the proper support for the muscles in your face that are needed for chewing and swallowing. These muscles are then strained as a result of improper positioning. This can lead to pain throughout your face, head, arms, shoulders, and back.

Who Suffers From TMJ?
Many people suffer from TMJ, often times not knowing the underlying cause of their facial pain. TMJ pain can affect men, women, and children.

How Can TMJ Be Treated?
TMJ pain can often times be treated. The main goal of treatment is to find your normal jaw position in which your muscles are most relaxed. The dentist will then work to realign the way you bite and this often times puts your jaws and TMJ in their proper position. Once the TMJ is placed in its proper position pain usually subsides.

Cosmetic Dentistry


Sometimes staining or slight chipping of front teeth can become noticeable and bothersome and a filling may not be the best option. Staining and chipping of teeth as well as gaps between front teeth can be fixed using lumineers. Lumineers are thinly shaped porcelain that can be put over your natural tooth structure to fix these issues.

Since the porcelain put over your natural tooth is so thin, it allows for minimal tooth preparation which in turn means little to no discomfort for you! Lumineers allows the dentist to do anything from slight changes and enhancing your smile to completely changing the way your front teeth look. Lumineers can be done in 1-2 visits depending on the circumstance.


Veneers are a great way to reshape and change your whole mouth. Veneers are a thin ceramic shell that goes over your existing tooth structure. These veneers are able to fix staining, spaces between teeth, chipped teeth, rotated teeth as well as many other issues.

The process of placing veneers takes anywhere from two to three visits. The dentist will work hand in hand with you to discuss your new smile. Everything from shape, size and color will be discussed to make sure that we will get the best results possible. Once a plan is in place the next step is to prepare the teeth for placement of the veneers. Once the preparations are complete an impression is taken of your mouth and sent to the lab. The lab will use the guidelines discussed with the dentist to make the veneers match what was discussed as best as possible. The process of fabricating the crowns usually takes the lab anywhere from 10 to 14 days. While these veneers are being fabricated a temporary veneer will be placed to allow you to see approximately what your new veneers will look like as well giving protection to the prepared teeth.

Once the lab completes fabrication we will try on the veneers and make sure they fit in with your natural smile. Once bonded in your mouth veneers will feel like your own teeth. Veneers need to be cared for with regular dental check-ups and home care including brushing and flossing.

Whitening & Bleaching

Many foods can cause staining of your teeth and sometimes regular cleanings and home care isn’t enough to sustain your bright smile. Foods such as coffee, wine, and spaghetti sauce can leave your teeth looking yellow over time. Teeth whitening is a great way to restore the natural color of your teeth or even make them whiter than they’ve ever been.

The process of teeth whitening is simple and you can get started in just one appointment. A whitening tray is made customized to your teeth. All that is needed is an impression of your mouth, and we will fabricate custom whitening trays. Once the trays are made you just fill the trays in at night with whitening gel and leave the trays in for a short period of time. Results can be seen in just a few days and often times your teeth become 4-8 shades whiter!


While whitening trays often times lead to great results, sometimes intense staining is best removed using Zoom chairside whitening system. Zoom is an in-office whitening system that can whiten your teeth in only one appointment! Have a wedding to go to? Maybe you’re going on vacation and you want to look your best. Zoom whitening can enhance your smile by whitening your teeth in as little as one hour.


Night Guard Root Canal (Endodontics)

Endodontics is the dental specialty that deals with the nerves of the teeth. Root canals are probably the most notorious procedure in dentistry and the most common procedure relating to endodontics. When a tooth becomes infected it is usually related to the nerves in the root of the tooth. The infected nerves need to be removed. If left untreated an infection can turn into an abscess, which is a much more serious problem that includes bone loss in the jaw.

The area around the tooth is numbed with a local anesthetic to start the procedure. The dentist will then drill down into the tooth to create an opening into the canal. They will then be able to remove infected tissue and clean the canal. After the infection has been removed, the space if filled with a sealant called gutta percha. It is highly recommended that a tooth that has undergone a root canal is fitted with a crown. This will improve the appearance of the tooth, and will also make it much more likely that the root canal is successful.

“Root canal” has become a scary term for dental patients to hear, but the benefits of the procedure and advances in dental technology have made it much less “scary”. Local anesthetics and proper pain medication allow the procedure to be performed with little to no pain in most cases. There may be some soreness following the procedure, but that is normal for most dental procedures. Over the counter painkillers are usually enough to relieve any pain afterwards, but your dentist may prescribe medication. The procedure will also relieve you from pain caused by the infection allowing you to enjoy all the foods you love without any pain from heat, cold, or biting too hard. If you are experiencing pain consult your dentist today.

Apicoectomy (Endodontic Surgery)

An apicoectomy is performed after an unsuccessful root canal. When an infection will not go away or returns after a root canal has been performed this procedure is usually necessary. There are many nerves that may contain the infected tissue, so it is difficult to ensure that all of the infection is removed during a root canal. During an apicoectomy, the tip of the root of the tooth is removed and replaced with a filling.

In mIn most cases a second root canal is considered before an apicoectomy since it is a simpler, less invasive procedure. Before the apicoectomy begins you will be given a local anesthetic to numb the area. The doctor will start by making an incision in your gum to expose the root of your tooth. Any inflamed tissue will be removed to clean out the area. The surgery takes place in a very small area, and only a few millimeters are removed from the root. For this reason, the doctor will use magnification and small precision instruments to perform the surgery. The precise nature of the surgery gives it a high rate of success. After the root is removed a filling is placed and the gums are sutured. Depending on the type of sutures you may have to return in a few days to have them removed, or dissolving sutures may be used instead. Over the course of the next few months the bone will heal around the root.

Endo Microscope

The use of the Endo Microscope allows a doctor to perform procedures with greater accuracy because the treatment area is magnified. The microscope’s superior illumination and magnification has made the greatest impact on visualization of the area, evaluation of surgical technique and use of fewer x-rays. With the unique ultrasonic unit and tips, a separated instrument or silver point can be removed with less effort. Fourth canals are now routinely being located and completely debrided in virtually all molars, thus increasing the long-term success rate with root canal therapy.


With proper care, most teeth that have had endodontic (root canal) treatment can last as long as other natural teeth. Root canals performed by endodontists (root canal specialists) have a 95% success rate. In some cases, however, a tooth that has received endodontic treatment fails to heal. Occasionally, the tooth becomes painful or diseased months or even years after successful treatment.

Why do I need retreatment?
As occasionally happens with any dental or medical procedure, a tooth may not heal as expected after initial treatment for a variety of reasons:

Narrow or curved canals were not treated during the initial procedure.
Complicated canal anatomy went undetected in the first procedure.
The placement of the crown or other restoration was delayed following the endodontic treatment.
The restoration did not prevent salivary contamination to the inside of the In other cases, a new problem can jeopardize a tooth that was successfully treated.

For example:
New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth. A loose, cracked or broken crown or filling can expose the tooth to a new infection. A tooth sustains a fracture. Retreatment is performed in two visits and involves the following:

  • At the initial visit the endodontist will examine the tooth, take x•At the initial visit the endodontist will examine the tooth, take x-rays and discuss your treatment options. If you and your endodontist choose retreatment, the retreatment will be scheduled at that time for a future date.
  • At the retreatment appointment the endodontist will administer local anesthetic to numb the tooth. After the tooth is numb, the endodontist will reopen your tooth to gain access to the root canal filling material. In many cases, complex restorative materials (crown, post and core material) must be disassembled and removed to permit access to the root canals.
  • After removing the canal filling, the endodontist can clean the canals and carefully examine the inside of your tooth using a microscope, searching for any additional canals or unusual anatomy that requires treatment.
  • After cleaning the canals, the endodontist will fill and seal the canals and place a temporary filling in the tooth. Post space may also be prepared at this time.
  • After your endodontist completes retreatment, you will need to return to your dentist as soon as possible to have a new crown or other restoration placed on the tooth to protect and restore it to full function.
  • If the canals are unusually narrow or blocked, your endodontist may recommend endodontic surgery.

Dental Implants

Dental implants are a permanent and appealing solution to replace missing or extracted teeth. They are better than other alternatives like bridges because no additional teeth need to be altered to place the new tooth.

The entire implant process is performed over the course of a few months. The first part of the process is to install the implant itself, where a screw is placed into the jaw bone. An incision is made in the gum so that the implant can be inserted. Multiple implants can be placed at once if necessary. After the implants are placed the gums are sutured.

The implant must be allowed about 3-6 months to heal, and during this time the jaw bone will form around the implant in a process called osseointegration. During this healing time you can have temporary crowns installed so that you can eat and speak normally and maintain a proper aesthetic appearance for your smile.

After the implant has healed it is time to place an abutment on the implant. The abutment serves as the base for your new tooth. One this is placed an impression of the abutment is taken and is used to create your permanent restoration. Some offices have an onsite lab to create the crown, but others will have to send it to an outside lab. Once the restoration is completed you can return to the office to attach the restoration permanently. Your smile will look just like it used to, and after a short period of getting used to the implant it will feel just like one of your own teeth.

Mini Implants

Mini dental implants are about half the size in diameter of a regular dental implant. This offers many benefits, and they can also be used in situations where regular implants cannot. If an implant needs to be placed in a narrow space, mini implants are the preferred method because of their smaller size.

A main use for mini implants is to install a full upper or lower denture. A series of mini implants (4-6) are placed along the gum line and they serve as the base of the denture. Rather than placing a single implant for a single tooth, an entire lower or upper set of teeth are directly attached to the gum line.

The small size of mini implants often means that no incision needs to be made to place the implant. They can usually be inserted right through the gum into the bone. This eliminates the need for a recovery period, and the restoration can usually be placed right away or only a short time after.

Mini implants are also less expensive than regular implants. Only your dentist knows if mini implants are right for you, so call for your consultation today.



Invisalign is a new system of straightening teeth without the use of conventional braces. A series of clear plastic aligners are utilized to create tooth movement. Moving teeth with removable aligners is not new. However, the computer program, which can generate a series of aligners with small changes is the new part. Invisalign is recommended for orthodontic situations with mild to moderate spacing or crowding. They are virtually undetectable, easy to use and comfortable to wear.

Clear Braces

Whether you’re an adult or a teen, we all want to look our best at all times. Changing the way your teeth are structured takes time and there are now ways to keep you looking your best during this period. Clear braces or ceramic braces are translucent. This new technology is available for most cases. The great benefit of these braces is that you won’t have to have that metallic look. In addition, clear braces are specifically designed so that they won’t stain or wear over time.

Give us a call today to see if you’re a candidate for ceramic braces!

Traditional Braces

Traditional braces have been around for many years. They are the standard among patients looking to straighten their smile. Today’s contemporary braces are made of exceptionally strong metals as they need to be able to stand the test of time while they are on your teeth. While contemporary braces are metallic colored, there are a number of bands and features that can be utilized to spruce them up. Give us a call today so we can discuss in more detail about getting you that perfect smile!

Pediatric Dentistry


Sealants are a great way to protect against tooth decay and cavities on your back teeth (molars). These are the teeth that are most vulnerable to cavities and decay because they are used in the chewing process, and are the most difficult to reach and clean. Molars first come in at around 5-7 years of age, with a second set coming in between the ages of 11-14. It is best to have a sealant placed when the molars first come in to ensure they are protected early. To place a sealant an adhesive is first applied to the teeth. The sealant is then placed over the adhesive as a liquid, as if it is painted right onto the tooth. The liquid then hardens and creates a barrier between your tooth and any plaque, food particles, and bacteria. Sealants last for about 10 years and can be reapplied if necessary.



You may have heard about gum disease, also known as “periodontitis” or “periodontal disease.” Maybe a dental professional or hygienist recently told you that you have this infection. But do you really know the difference between periodontal disease and other types of complications that can affect your mouth, such as gingivitis? Do you know why it’s so important to treat periodontal disease-and why brushing and flossing alone won’t do the trick?

Most importantly, did you know that periodontal disease is today’s #1 cause of tooth loss among American adults? Or that, although a causal relationship between periodontal disease and an elevated risk for systemic events has not been established,recent data suggest a possible association between periodontal disease and other health issues including cardiovascular disease, diabetes, and preterm low birth-weight babies?

Fight infection right where it starts
ARESTIN® (minocycline hydrochloride) Microspheres, 1 mg is an effective antibiotic treatment that comes in powder form. This powder is placed inside infected periodontal pockets just after the dental professional finishes the scaling and root planing (SRP) procedure.

Canine Exposure for Orthodontics

Canine exposure has nothing to do with leaving your dog outside, exposed to the elements. It is a procedure to expose impacted teeth. An impacted tooth is one that has not erupted in the mouth, but instead becomes stuck in the surrounding bone or tissue. Any tooth may become impacted, but generally, the wisdom teeth and canine teeth are the most likely candidates. Canine teeth are critical for function. The mouth will also appear aesthetically odd without the canines. The procedure is quite simple. It involves the dentist cutting a small hole in the gum, which allows the tooth to erupt. The dentist also uses a dental brace to guide the tooth into its correct position.

Impacted teeth are sometimes obvious to the naked eye, but in some instances, an x-ray is necessary to identify the extent of the impaction. Many times, there is an impacted canine tooth where the baby tooth remains in the mouth. A loose tooth is also a sign that an impacted tooth may be present.


Throughout the medical field, a biopsy is simply the removal of a tissue sample to determine if it is diseases. In dentistry, teeth and gums are sent for biopsy. The role of a biopsy in the dental industry is to diagnose oral cancer. In these instances, a brush biopsy is used to identify oral lesions that warrant further attention.

If you have unexplained lesions in your mouth, they need to be examined by a dentist. They may or may not be cancerous, but they need medical attention nonetheless.

Bone Grafting

Bone grafting is where the jawbone is built up to accommodate a dental implant or other restorative device. Bone grafting is a common procedure that is used frequently for dental implants and other periodontal procedures. The bone used to graft is taken from a sample from the patient. Many times, the bone is taken from another area of the mouth when drilling takes place. The bone fragments are suctioned from the mouth and used for the graft. Cadaver bone fragments are also used. They are harvested by bone banks and are a very safe source for bone donation.

Crown Lengthening

It is no secret that dentists are committed to saving teeth. This is why we fill a cavity, instead of pulling the tooth.

Cavities can decay to tooth to the point where restoration is virtually impossible without a procedure called crown lengthening. Crown lengthening is a routine surgical procedure, which remodels the contour of the gum line. The procedure does not actually lengthen the crown, but rather lowers the gum line. When there is not enough tooth structure to affix a crown, this is the only option. Sometimes a tooth has been broken below the gum line. In this instance, crown lengthening is very successful in exposing more of the tooth, so that the dentist has something to work with.


A frenulum is a piece of tissue that prevents an organ from moving. There is a frenulum that attaches your upper lip to the gums, while another connects the lower lip to the gums. A frenulum that is too short or thick, will cause problems in speech patterns and tooth misalignment. In infants, a shortened frenulum underneath the tongue will inhibit breastfeeding. When the frenulum disrupts movement, growth, or development, corrective action is necessary to resolve the situation.

A frenectomy is a minor surgical procedure that is performed in your dentist’s office. It can be performed with either a scalpel or laser and takes less than 15 minutes. Using a laser causes very little bleeding and does not require stitches. A laser also results in less postoperative discomfort and a shorter healing time. Young children and infants are put under general anesthesia for the procedure and adults have the procedure performed using local anesthesia. If your child needs a frenectomy, there is nothing to worry about. The procedure is very successful and causes minimal discomfort.

Gingival/Gum Grafting

Gingivitis and in its advanced state, periodontitis, has a profound effect on the gums. As gingivitis progresses, more and more bacteria and plaque builds up, causing the gums to stretch. The end result it large pockets, that once they are cleaned out, remain on your gum line. These pockets cause the gums to recede, which aesthetically not pleasing to the eye. When the gums recede, an abnormal amount of tooth structure is exposed.

Gum grafting is the corrective procedure that restores the gum to its natural, healthy state. Using soft gum tissue from the roof of the mouth, the receded gums are grafted. The goal if the graft is to cover exposed tooth and root surfaces with grafted on oral tissue. This grafting encourages new tissue growth that will enable the gums to return to its original position around the teeth. The procedure is routine and entails a minimal amount of downtime and discomfort.

Periodontal (Gum) Disease

Periodontal (gum) disease is insidious. It is an infection of the gums that starts out as plaque, an opaque film on the teeth that hardens to form tartar. As tartar accumulates, it harbors bacteria that attack the soft tissue around the gums. This is the early stage of gum disease known as Gingivitis. Left untreated, Gingivitis becomes Periodontitis which ultimately destroys the tissue surrounding your teeth AND the bone that holds your teeth in place. Except for bad breath and gums that bleed, there are very few early warning signals. The disease advances silently, often without pain, and before you know it, you are losing your teeth and you don’t know why.

Tooth loss is only the most obvious indicator of gum disease. Scientific research has discovered linkage between gum disease and stroke, heart disease, diabetes – even an increased risk for pregnant women. When your gums become diseased, your entire immune system is weakened.

In the past, fear of painful dental surgery has kept people with gum disease from seeking the care they needed. Well, those days are gone forever.

Scaling & Root Planing

Gingivitis is a generative disease that left untreated, will cause significant tooth and gum deterioration. Just the word gingivitis can strike panic in a patient’s mind. The reality is that the treatment is simple and performed right in your dentist’s office.

Plaque and tarter that sits on the teeth provides an environment, which allows bacteria to thrive and multiply. The bacteria cause the gums to become inflamed and bleed. The condition becomes more noticeable when you brush your teeth or sometimes when you eat. These are signs of the early stage of gingivitis. Gingivitis is easily treated by having the hygienist scaling and polishing the teeth. If gingivitis is left untreated, the condition will progress and the roots will need a planing. The difference between scaling and root planing is simple. Scaling is the removal of the dental tartar from the tooth surface Root planing is the process of smoothening the root surfaces and removing the infected tooth structure.

As a non-surgical procedure, scaling and planing is performed without any anesthesia, in the dentist’s office. While the procedure is usually painless, advanced stages of gingivitis may make it necessary to numb the area for complete comfort. Deep scaling and root planing is usually broken down into one section of the mouth per appointment. This allows for adequate healing time, and reduces the time for each appointment.

Soft Tissue Graft

A soft tissue graft is used when there has been a significant amount of gum recession in a particular area. Slight gum recession can usually be fixed with a few changes to your oral hygiene routine to take better care of your teeth and gums. When the gingiva recedes further it exposes you to greater risk for infection and bacterial penetration. You will likely be more sensitive to hot and cold foods when you have receding gums. If the gums recede enough as to expose the root you can set yourself up for more serious problems. The root is softer than the enamel making it more vulnerable to bacteria and plaque.

To restore proper gum level and functionality a soft tissue graft can be performed. This is done by either removing soft tissue from the roof of the mouth, or repositioning healthy gum tissue from adjacent teeth. This procedure is very predictable and has a high success rate. This procedure should be performed before more serious problems develop and periodontal surgery is necessary.

Occlusal Adjustment

Do you wake in the morning with sore jaws? When you bite, do you feel like your jaw is lopsided? If so, then you may need an occlusal adjustment.

An occlusal adjustment corrects the alignment of the bite, that is a result of loose, shifting, crowded, or missing teeth. The result is an evenly distributed bite that eliminates irregular pressure on one side of the mouth. Once your bite is adjusted, your teeth will meet properly. Occlusal adjustment causes minimal pain, and only a little discomfort. The adjustment is made by using a dental drill using a fine filing stone. In addition to the actual adjustment, removal mouthpieces are also utilized, to protect the tooth surface, and relax the jaw muscles once the adjustment is completed.

Who is a good candidate for an occlusal adjustment? Patients with loose or shifting teeth will many times not meet correctly. Patients, who grind or clench their teeth, will have an uneven bite and pressure distribution in the mouth, which is also corrected through an occlusal adjustment. Sometimes tooth sensitivity can be corrected through an occlusal adjustment as the treatment reduces pressure on the sensitive tooth.

New technology allows dentists to accurately identify the areas, which need adjustments. The dentist utilizes a computer scan of the mouth, which records hundreds of bite registrations per minute, and notes even the slightest irregularity. That data allows the dentist to make only the adjustments that are absolutely necessary, which ensures a well aligned bite and minimal tooth wear.

Periodontal Splinting (Weak Teeth)

Loose teeth are uncomfortable, especially when you try to eat food or chew gum. The feeling of the tooth pulling away from the gum is enough to send chills down your spine. It seems like an eternity, waiting for either the tooth to become loose enough to be extracted or strong enough to no longer be a problem.

Teeth become loose because of lost gum tissue, injury, orthodontic treatment, or pressure caused by tooth misalignment. A new technique called periodontal splinting attaches weak teeth together, turning them into a single unit that is stable and stronger than the single teeth by themselves. The procedure is most commonly performed on the front teeth. The procedure is as simple as using composite material to attach, or splint, the loose teeth to the adjoining stable teeth. Tooth splinting is a common procedure that has gained popularity due to its effectiveness.

Osseous Surgery/Pocket Reduction

Sometimes the effects of periodontal disease create permanent changes in the tooth and gum structure that will cause issues in the future. Enlarged gum pockets between the tooth and the gum line are common after having advanced gum disease. Sometimes these gaps are cosmetic in nature, and affect the appearance of the gums. More commonly, the gaps put the teeth at future risk for tooth and gum disease, as they are just one more place that plaque and bacteria can collect. Pocket reduction surgery is designed to thwart the after effects of periodontal disease and restore your mouth to a healthy state.

The goal of periodontal surgery to gain access to the tooth root and to clean the damaged areas. Once the dentist can visually see the damage, it can be removed completely. Removing the plaque and decayed gum tissue leaves a pocket between the gum and the tooth. Sometimes the gum returns to its original position, but still the pocket is present. The pocket requires more frequent cleanings as the patient is unable to get to the pockets with regular brushing and flossing. Once the swelling from the periodontal treatment has subsided, the dentist may need to suture the gum to where the bone has resorbed. The goal is to create a space large enough so it can be reached through daily oral hygiene, but small enough that it is not a breeding ground for plaque and bacteria.

Cosmetic Periodontal Surgery

Your smile is the first thing someone notices about you. People form their first impressions based on the appearance of your smile. There was a time when, unless you made allot of money or were born with perfect teeth, you had to live with your smile. Today, a wide range of cosmetic procedures is available to the average citizen, at a cost they can afford. If you have a gummy smile, uneven gum line or elongated teeth, cosmetic periodontal surgery is for you.

Cosmetic periodontal surgery sculpts the gum line so that it is even and in proportion to the amount of exposed tooth versus gum. This procedure removes the excess gum and exposes more of the tooth crown. If your gums have receded, and your teeth appear overly long, then soft tissue grafts can extend the gum line to create an aesthetic balance. The grafts also reduce the gum pockets that are prone to future periodontal disease.

Osseous Grafting/Guided Tissue Regeneration

Osseous surgery is a procedure that reshapes the bone which holds your teeth in place. Osseous surgery commonly treats periodontitis. Patients with periodontitis experience defects in the bone around their teeth. The osseous surgery removes those defects. Prior to the surgery, the patient undergoes a periodontal treatment that consists or scaling and root planing. A local anesthetic is administered to minimize the pain. Once the roots are cleaned, the dentist uses a drill and sharp dental tool to reshape the bone surrounding the teeth. Depending on the extent of the defects, the deformed bone is removed, and the rest is shaped. Bone grafting material is used where the defects are too large to be treated with only reshaping. Once the bones are back to their original state, the gums are stitched back into place. Osseous Grafting is a routine procedure, with a high success rate.

Digital X-Rays
Digital x-rays are being adopted by many dentist through the country. A digital x-ray allows the dentist to take an image of a tooth and put it directly into an imaging program. This imaging program allows the dentist to change the image of the tooth to aid in diagnosing problems. The imaging program also allows the dentist to enhance and magnify the image to allow issues to be seen that may have previously gone unnoticed.

The benefits of digital x-rays are that there is nearly 80% less radiation with a digital x-ray versus standard x-rays. Digital x-rays also allow the image to be seen within seconds of taking it rather than needing to go through the process of manually developing the film.

Electrical Handpieces
There are basically two types of handpieces, air-driven and electric. Electric handpieces are much stronger than air-driven due to the fact that a motor is spinning the bur as opposed to air. This allows the doctor to remove decay at a faster pace. This will cut down on the time it takes to complete a procedure.
Intraoral Cameras
The intraoral camera is an amazing diagnostic tool for viewing different angles in the mouth that we would not have been able to just a few years ago. The camera gives us the ability to view the entire mouth on a monitor so that we can get a closer look at any potential issues or problems that may arise. In addition, the patient will have the ability to see for themselves first hand the same images we are seeing. These digital images are also excellent for gaining procedure acceptance from insurance companies.
Oral Cancer Screenings
Oral cancer screenings are a very important part of the dental visit for the patient. With the advances in modern technology, we are now able to pinpoint the start of a potential problem much earlier in its evolution. The ability to do so is extremely important in being able to treat any issues prior to them becoming a major irreversible problem.

The oral cancer screening is often completed with an ultraviolet light or similar device that allows us to view issues that can’t always be detected by the human eye under normal conditions.

Certain lifestyle choices can have a great impact on the health of tissues and your overall health in the mouth. If you are a smoker or heavy drinker, make sure to get regular screenings when you visit the dentist.

Panoramic Radiograph
A panorex is a very impressive piece of imaging machinery in that it is capable of identifying many issues and structures that a normal x-ray is not. Initially you will sit in a chair with your chin on a small ledge. Once positioned in the machine, it will rotate around your entire head taking a full 360 degree view of the teeth, head, sinuses and bones.

The ability to view the full structure of your head as a whole is very informative to the dentist. It will allow us to see any potential problems and make sure that everything is functioning as it should be. The panorex is capable of viewing specific types of structural problems, infections or asymmetry among many others.

Rotary Endodontics
Endodontics, more commonly known as root canal, is a procedure where the roots or nerves of the tooth are removed. This is often due to the fact that they are infected and the tooth is causing pain.

Rotary Endodontics is a way of performing the root canal utilizing a specific electrical handpiece. This tool often makes the process faster and allows the dentist to perform the process with greater ease.

Sedation Options

Oral Conscious Sedation

If the idea of going to the dentist for a procedure brings on feelings of fear or anxiety there are options to ease the anxiety. Oral conscious sedation is as easy as taking an aspirin and you will feel relaxed and at ease. Oral conscious sedation does not “knock you out” like some other forms of anesthesia. You will remain awake during your procedure, but you will be in a heightened state of relaxation. It is also possible that you will not remember part, or all, of your procedure.

Oral conscious sedation is extremely safe and easy. It is much less expensive than other forms of sedation, and you will be able to talk and breathe on your own during the procedure. It also makes long or complex procedures seem shorter, allowing you to have all of your work done in a single visit. As an added precaution a local anesthetic will be given to the area that is being worked on to ensure that there is no pain. You will need to have someone drive you to and from the office if you use oral conscious sedation for your safety.

IV Sedation

If the idea of going to the dentist for a procedure brings on feelings of fear or anxiety there are options to ease the anxiety. IV sedation is very safe and easy and is recommended for moderate to severe anxiety. Medication is given right into your bloodstream and it works quickly and effectively. You will remain awake during your procedure, but you will be in a heightened state of relaxation. It is also possible that you will not remember part or all of your procedure afterwards.

IV sedation makes long or complex procedures seem shorter, allowing you to have all of your work done in a single visit in many cases. As an added precaution a local anesthetic will be given to the area that is being worked on to ensure that there is no pain. The benefit of IV sedation is that the level of medication can be adjusted during your procedure to ensure maximum comfort. Your heart rate and breathing are monitored very closely while you are being medicated because your safety is our number one concern.


Anxiolysis is a form of oral sedation using a light sedative, such as valium. It is not as strong as oral conscious sedation, so it is recommended for those with mild to moderate anxiety. You will remain conscious for the procedure, but any tension and anxiety will fade away. You will be able to talk and breathe on your own during the procedure as well. What can be a nerve-racking experience for some is morphed into a relaxing experience. After the procedure you will even be able to drive yourself home since anxiolysis uses a light sedative.

Nitrous Oxide

Nitrous Oxide, known to many as laughing gas, is the most commonly used form of sedation in dentistry. It is administered by having the patient inhale the gas, which is carefully monitored by your doctor. You will fall into a euphoric state and feel completely relaxed. All feelings of fear and anxiety fade away, leaving you to sit back peacefully while your dental procedure is performed. In most cases all dental work can be completed in one visit while you are sedated.

Nitrous oxide sedation is very safe and effective. Once the procedure is over the nitrous oxide will wear off fairly quickly, and you will probably be able to drive yourself home and return to your daily activities. You will need to have a preliminary visit with your dentist to make sure that you are an eligible candidate for nitrous sedation.


Sedation FAQs
Who is a candidate for sedation?
If you have anxiety or fear about going to the dentist you are a candidate for sedation dentistry. If you have a fear of pain, have had a traumatic dental experience in the past, or the sounds and smells of a dental office make you nauseous, sedation dentistry can help you get over your anxiety.

Some people have physical reasons, like a bad gag reflex or very sensitive teeth, which make them a candidate for sedation dentistry as well. If you are not sure if you are a candidate ask your dentist.

Will I be unconscious?
No, but you will be in a deep state of relaxation during your treatment. You will still be able to breathe on your own and communicate, but you will not feel any pain or anxiety. You may not even remember the procedure afterwards.

How long will I be sedated?
Sedation can last from about 2-6 hours depending on the strength of sedative you are given and how long your procedure takes.

Will I be monitored?
Yes, at all times during your sedation someone will be with you. We also monitor your vitals to make sure they remain at a normal level. Safety is of the utmost importance to us.

Are there any long term effects of sedation?
No. You will feel a little groggy and “out of it” after some forms of sedation, but after a few hours you will feel like yourself again. You will need to have someone drive you home from your appointment in these cases.

What procedures can be performed under sedation?
Just about any procedure can be performed with sedation. The sedation is not for the procedure itself, but for the anxiety that accompanies the procedure. Ask your dentist if sedation is available for a particular procedure.

How many appointments will I need to complete my dental work?
In most cases it only takes two appointments. The first appointment will be a consultation to check your health history and make sure you are a candidate for sedation. The next appointment will be to perform the necessary procedures. This can usually be done in one appointment, but may require a follow up visit.

Will my insurance cover sedation?
In most cases it will not be covered by your insurance provider. We will review your insurance coverage and let you know if it is covered or not. If it is not covered, we will let you know the cost and, if necessary, we can put together a financing plan for you.

Patented Hydrophotonic™ Technology
Waterlase® Dentistry uses a patented technology combining YSGG laser energy and a spray of water, a process called HydroPhotonics™, to perform a wide range of dental procedures on teeth, gum and bone more comfortably. Typically, Waterlase Dentists use fewer shots and less anesthesia reducing patient anxiety and providing a more relaxing dental experience.

Fewer Shots & Less Anesthesia
Waterlase® is a versatile tool that allows dentists to cut teeth, bone and gum tissue with less trauma and do procedures that can’t be done with traditional tools such as the drill and scalpel. Your Waterlase® dentist will determine what type of treatment is appropriate for your needs.

Proven Technology, Comfortable Care
Lasers have long been the standard of care in medicine for many surgical and cosmetic procedures such as LASIK, wrinkle removal, hair removal and many others. The Waterlase® was approved for hard tissue procedures in 1998 and since has been cleared for numerous additional dental procedures. Thousands of dentists around the world have performed millions of procedures with less need for shots, anesthesia, drills and post-op numb lips.

Patient Comfort
Heat, vibration and pressure are the primary causes of pain associated with the use of the traditional dental drill. Since cutting both hard and soft tissues (teeth and gums) with the Waterlase® does not generate heat, vibration or pressure, many dental procedures can be performed with fewer shots, less need for anesthesia, less use of the drill and fewer numb lips! Additionally, using the Waterlase® for gum procedures reduces bleeding, post-operative pain, swelling and the need for pain medication in many cases.

Accuracy & Precision
Waterlase® dentists are able to remove tooth enamel decay (the hardest substance in the body), bone and gum tissue precisely while leaving surrounding areas unaffected. This conserves and allows you to keep more of the healthy tooth structure.

Reduced Trauma
High speed drills can cause hairline cracks and fractures in the teeth that eventually lead to future dental problems. Waterlase® reduces damage to healthy portions of the tooth and minimizes trauma.

Improved Cavity
Fillings Waterlase® cavity preparations can increase bond strength of tooth-colored restoration resulting in longer lasting fillings.

Less Bleeding & Swelling
Due to its conservative, gentle cutting action and coagulating capabilities, the Waterlase® performs many soft tissue (gum) procedures with little or no bleeding and less post-op swelling.

Fewer Dental Visits
Since you often do not need shots or anesthesia, a Waterlase® dentist can perform cavity preps in all areas of the mouth in just one visit. This technology also gives trained Waterlase® dentists the ability to perform many procedures that were previously referred to specialists.

The Waterlase® is extremely versatile. It can be used for a wide range of hard and soft tissue procedures. From decay removal, cavity preparation, root canals, smile design, gum and bone surgical procedures and many others.