Your First Visit and
During your first visit, you can expect either Dr. Adam or Dr. Mindy Garfinkle to perform a thorough examination. This exam will include necessary radiographs (x-rays) allowing us to diagnose the condition of the mouth, teeth and gums. We proudly provide only the highest quality, low radiation digital radiographs. Digital x-rays use an estimated 40-90% less radiation than conventional film x-rays. Digital x-rays use a digital image capture device in place of traditional film, sending an image immediately to a computer. The result is a highly-detailed image of the mouth, and its contrast and resolution can be enhanced to more easily diagnose dental problems and determine the very best treatment for each case. This means more safety and better accuracy for you.
A visual inspection can help your dentist spot most oral health problems, including cavities, periodontal (gum) disease, oral cancer and/or jaw/bite issues. In most instances, your dental condition will be determined at this visit and if needed, a plan of treatment will be discussed with you. Please allow our knowledgeable dental team the opportunity to demonstrate to you how well we take care of our patients. Why not schedule your first visit with us today?
The state of your mouth can indicate problems in other areas of your body, so visiting your dentist every six months can help you maintain your overall well-being. A cavity, for instance, can advance to the center of the tooth and cause a localized infection. If not treated with root canal therapy, the bacteria can enter the bloodstream and cause a serious systemic infection. Likewise, studies have proven a link between gum disease and health conditions such as diabetes, dementia and cardiovascular disease, so it pays to undergo routine checkups to spot gum disease in the early stages when it is reversible so that you can reduce your risk of other health problems.
Routine Dental Cleanings
A Prophylaxis (D1110) is a professional cleaning you receive from a dentist or dental hygienist, in the absense of active periodontal (gum) disease. A Periodontal Maintenance (D4910) cleaning is a professional cleaning you receive if you have a history of periodontal disease/unhealthy gum tissue. Most dental cleanings take only thirty (30) minutes and they are a must, helping to keep your teeth healthy and white. Try as hard as you will, you cannot keep your teeth clean by brushing and flossing alone; over a period of time, stains and plaque build up on the teeth. Having your teeth professionally cleaned is important both for your health and for your appearance. The removal of stain and deposits helps ensure that your gums and the bones supporting your teeth remain healthy and makes your smile more attractive. Recent studies show that most people over the age of forty (40) have some form of gum disease. Routine cleanings help prevent gum disease and can help manage already existing gum disease which prevents eventual tooth loss. Have your teeth professionally cleaned at least every six (6) months and every three (3) months if you have gum disease.
Deep Cleanings (SRP)
During your oral examination, a dental professional will use an instrument called a "probe" to measure the area around your teeth to see if you have any pocketing (area between the tooth and gum where bacteria will form). The depth of the gum tissue between the teeth and gums are called pockets when it is five millimeters or more. The American Academy of Periodontology recommends that every adult receive this kind of periodontal evaluation each year to determine whether additional treatment is needed. Measuring pocket depth is just one part of a comprehensive dental evaluation. In the more advanced stages of periodontal disease, your dental professional will likely recommend this type of cleaning, which consists of removing plaque and tartar below the gumline. A "deep cleaning" is the simple term for the dental procedure known as Scaling and Root Planing (D4341-D4342).
When you have pocketing like the last three teeth in the image above, a deep cleaning is necessary. This procedure involves removing the bacterial toxins on the surfaces of the tooth roots to help the gums reattach to the teeth and eliminate periodontal pockets. To ensure comfort during this procedure, numbing of the area being cleaned will take place. Dentists or Dental Hygienists traditionally perform the scaling by hand, however, new and advanced technology has led to more modern methods such as electric scalers. This sophisticated tool allows dental cleanings to be performed more efficiently and in less time. Both electric and manual scaling methods can be combined to achieve the best results. Following a deep cleaning, a maintenance cleaning known as Periodontal Maintenance is then performed every three (3) months until a dentist decided more months between visits can be allowed.
A dental sealant is a thin, plastic coating painted on the chewing surfaces of teeth — usually the back teeth (the premolars and molars) — to prevent tooth decay. Most teeth have grooves that a toothbrush bristle is simply too big to reach the bottom of. The sealant quickly bonds into the depressions and grooves of the teeth, forming a protective shield over the enamel of each tooth. Dental sealants have been used and have been proven to be effective since the 1970s. Many studies have shown that they are effective in helping to prevent decay on chewing (occlusal) surfaces. Dental sealants can last many years, and are much more affordable than repairing cavities that can form in these grooves. If necessary, it is also possible to place new dental sealants on the teeth if the previous ones have worn out.
The chewing surfaces of the molar and premolar teeth have grooves — "fissures" — that make them vulnerable to decay. These fissures can be deep, are difficult to clean, and can be narrower than even a single bristle of a toothbrush. Plaque accumulates in these areas, and the acid from bacteria in the plaque attacks the enamel and cavities can develop. Fluoride helps prevent decay and helps protect all the surfaces of the teeth, dental sealants provide extra protection for the grooved and pitted areas by providing a smooth surface covering over the fissured area.
Dentists have used in-office fluoride treatments for decades to help protect the oral health of children and adults, especially patients who may be at a higher risk of developing caries. Some factors that may increase a person’s risk of developing caries include poor oral hygiene, other active caries, eating disorders, drug or alcohol abuse, lack of regular professional dental visits, active orthodontic treatment (braces), high levels of oral bacteria, exposed root surfaces of teeth, decreased salivary flow (dry mouth), poor diet, existing restorations (fillings), tooth enamel defects and undergoing head and neck radiation therapy.
Professional fluoride treatments generally only take a few minutes. The fluoride may be in the form of a solution, gel, foam or varnish. Typically, it is applied with a cotton swab or brush, or it is used as a rinse or placed in a tray that is held in the mouth for several minutes. After the treatment, you may be asked not to rinse, eat or drink for at least 30 minutes to allow the teeth to absorb the fluoride and help repair microscopic carious areas. Depending on your oral health status, fluoride treatments may be recommended every three, six or 12 months. Your dentist also may recommend additional preventive measures if you are at a moderate or high risk of developing caries. These measures may include over-the-counter or prescription therapeutic products such as fluoride mouthrinses, gels or antibacterial mouthrinses. To read more about the American Dental Associations input on fluoride treatments, click here.
Oral Cancer Screening
Oral cancer screening are an examination performed by a dentist or doctor to look for signs of cancer or precancerous conditions in your mouth. The goal of oral cancer screening is to identify mouth cancer early, when there is a greater chance for a cure. Most dentists perform an examination of your mouth during a routine dental visit to screen for oral cancer. Some dentists may use additional tests to aid in identifying areas of abnormal cells in your mouth. Drs. Adam and Mindy Garfinkle will assess your individual needs and determine if further testing is needed.
Tooth Colored Fillings
If your teeth are chipped, cracked or damaged by tooth decay, they need fillings. Large cavities are obvious and often painful, but small pinhole cavities and hard-to-see areas between teeth may also need attention. Your dentist can find cavities and sites of tooth decay that you may not see in the mirror. X-rays, dental probes and dyes can reveal areas that need dental restoration. Your dentist can also see areas that you may not be able to spot, which is one reason why regular dental check-ups are vital for your oral health. Regular visits allow the dentist to see small problems before they become large ones. Although cavities are the most common reason for fillings, they are not the only reason your dentist may recommend reconstructive work. If you grind your teeth, bite your nails or otherwise use your teeth as tools, you may erode the chewing surfaces enough to require a filling to restore a healthy bite.
A composite filling is a tooth-colored plastic and glass mixture used to restore decayed teeth. Composites are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth - See Tooth Bonding. Following preparation, the dentist places the composite in layers, typically using a light specialized to harden each layer. When the process is finished, the dentist will shape the composite to fit the tooth. The dentist then polishes the composite to prevent staining and early wear. Prices vary for tooth colored fillings, but composites can cost up to two times the price of a silver filling. Most dental insurance plans cover the cost of the composite up to the price of a silver filling, with the patient paying the difference. As composites continue to improve, insurance companies are more likely to increase their coverage of composites. Aesthetics are the main advantage of composites, since dentists can blend shades to create a color nearly identical to that of the actual tooth. Composites bond to the tooth to support the remaining tooth structure, which helps to prevent breakage and insulate the tooth from excessive temperature changes. If you have more questions or concerns about tooth colored fillings, give us a call to schedule a free consultation!
Inlay & Onlay Restorations
Dental inlays and onlays are restorations used to repair rear teeth with mild to moderate decay or cracked and fractured teeth that are not sufficiently damaged to need a crown. Ideal candidates for inlay or onlay work typically have too much damage or decay in the tooth structure to be successfully treated using a filling, but have sufficient healthy tooth remaining to avoid the need for a crown. This allows the dentist to conserve more of the patient’s original tooth structure. Dental inlays and onlays are used when old fillings need to be removed or replaced. A dental inlay is similar to a filling and fits inside the cusp tips (top edges) of the tooth. A dental onlay is more extensive and extends over the cusps of the treated tooth.
During treatment the dentist will removes the old filling/cavity under local anesthesia and takes an impression of the tooth, which is sent to the dental laboratory. The new inlay or onlay is made from this mold in porcelain, gold or composite resin material. The inlay or onlay is then cemented into place at the next appointment. The inlay or onlay blends successfully with the treated tooth and the rest of the teeth to achieve a natural, uniform appearance.
Tooth loss is a celebrated event during childhood, but losing teeth as an adult can be devastating. Not only will you suffer the cosmetic embarrassment of a gapped smile, but you will also develop numerous problems with your oral health if you do not replace the missing teeth. Biting and chewing food will become more difficult, and your remaining teeth will start to shift out of place because tooth loss creates extra room for them to do so. Your bone health will also suffer because tooth roots provide stimulation to the jawbone to keep it dense and strong. Once the body stops sending nutrients to the area of the jawbone where a tooth is missing, the bone will deteriorate and give your face an aged, sunken appearance. Fortunately, dental implants can prevent all of these issues. Dental implants are frequently the best option for replacing missing teeth. Rather than removable dentures, or fixed bridges, dental implants are the long-term replacements of choice. The implant is an artificial root usually made of titanium that your implant specialist surgically places in the jawbone.
After more than twenty (20) years of service, the vast majority of dental implants first placed by oral and maxillofacial surgeons in the United States continue to function at peak performance. More importantly, the recipients of those early dental implants are still satisfied they made the right choice. If properly cared for, dental implants can last a lifetime. While other tooth replacement methods are still in use today, dental implants are the gold standard for a reason. Dentures are designed to stay in place with suction or by attaching to your remaining teeth with clasps. While they may fit perfectly when you first receive them, the natural bone loss that occurs with missing teeth can make them lose their fit over time, causing patients to experience embarrassing slippage on a regular basis. Bridges are another common tooth replacement option, but they require the reduction of healthy tooth structure for crown placement. Implants do not pose any of these issues. Because your new restorations are permanently anchored into your mouth, you can enjoy speaking and eating without worrying about your teeth slipping out of place. In addition to helping you maintain the healthy structure of your remaining teeth, they look and feel just like your natural teeth and stimulate your jawbone to help preserve a youthful facial appearance.
A bridge is made the same way as a crown — in fact a bridge is several crowns attached together. A bridge may be recommended if you're missing one or more teeth. Gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into the empty spaces, resulting in a bad bite. The imbalance caused by missing teeth can also lead to gum disease and temporomandibular joint (TMJ) disorders.
Bridges are commonly used to replace one or more missing teeth. They span the space where the teeth are missing. Bridges are cemented to the natural teeth or implants surrounding the empty space. These teeth, called abutments, serve as anchors for the bridge. A replacement tooth, called a pontic, is attached to the crowns that cover the abutments. The pontic fills the empty space. As with crowns, you have a choice of materials for bridges. Your dentist can help you decide which to use, based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost. Porcelain or ceramic bridges can be matched to the color of your natural teeth or can be made as white as you'd like your smile to be.
Before a bridge can be made, the tooth (or teeth) must be reduced in size so the bridge will fit over it properly. After reducing the tooth/teeth, your dentist will take an impression to provide an exact mold for the bridge. If porcelain is to be used, your dentist will determine the correct shade for the bridge to match the color of your existing teeth. Using this impression, a dental lab then makes your bridge in the material your dentist specifies. A temporary bridge will be put in place to cover the prepared tooth while the permanent bridge is being made. When the permanent bridge is ready, the temporary bridge is removed, and the new bridge is cemented over your prepared tooth or teeth.
A crown is a type of dental restoration that, when cemented into place, fully cups over that portion of a tooth that lies at and above the gum line. Since it encases the entire visible aspect of a tooth, a dental crown, in effect, becomes the tooth's new outer surface. In comparison, dental fillings are restorations that fill in or patch just a portion of a tooth. Other terms that are used to refer to crowns are "dental caps" and "tooth caps". Crowns can be made out of porcelain, metal (a gold or other metal alloy) or a combination of both (porcelain-fused-to-metal).
Dental crowns are fabricated in a dental laboratory using the impression your dentist has made of your tooth after having prepared it. Using the impression, a lab technician can visualize and examine all aspects of your bite and jaw movements. Because dental crowns encase the visible portion of a tooth, any porcelain crown (all-ceramic or porcelain-fused-to-metal ones) can be used to enhance the cosmetic appearance of any tooth.
Dentures are a type of prosthesis (an artificial body part) used to accommodate some or all missing teeth. These devices are typically removable, but some are bonded or implanted. When all teeth are absent, complete dentures are used. When only some teeth are missing, partial dentures are used. Dentures may be for the maxillary (upper) arch, mandibular (lower) arch or both.
Dentures can be conventional or immediate. Made after the teeth have been removed and the gum tissue has begun to heal, a conventional denture is ready for placement in the mouth about eight (8) to twelve (12) weeks after the teeth have been removed. Unlike conventional dentures, immediate dentures are made in advance and can be positioned as soon as the teeth are removed. As a result, the wearer does not have to be without teeth during the healing period. However, bones and gums shrink over time, especially during the healing period following tooth removal. A disadvantage of immediate dentures compared with conventional dentures is that they require more adjustments to fit properly during the healing process, and generally should only be considered a temporary solution until conventional dentures can be made.
A removable partial denture (not a bridge, which is a fixed prosthesis) usually consists of replacement teeth attached to a pink or gum-colored plastic base, which is connected by metal framework that holds the denture in place in the mouth. Partial dentures are used when one or more natural teeth remain in the upper or lower jaw. Not only does a partial denture fill in the spaces created by missing teeth, it prevents other teeth from changing position. A precision partial denture has internal attachments rather than clasps that attach to the adjacent crowns. This is a more natural-looking appliance. Give us a call today to schedule your complementary denture consultation to find out more about your specific options (818) 532-2977.
Tooth Shaping & Bonding
Bonding is the application of a tooth-colored composite resin (plastic) to repair a decayed, chipped, fractured, discolored tooth, to make teeth appear longer, and as a cosmetic alternative to amalgam fillings. Bonding can be done in a single visit to your dentist. Bonding is among the easiest and least expensive cosmetic dental procedure. The composite resin used in bonding can be shaped and polished to match the surrounding teeth. Most often, bonding is used for cosmetic purposes to improve the appearance of a discolored or chipped tooth. It also can be used to close spaces between teeth, to make teeth look longer or to change the shape or color of teeth. Sometimes bonding is used as a cosmetic alternative to fillings, or to protect a portion of the tooth's root that has been exposed because of gum recession.
The first step is to schedule a consultation with your dentist so you can discuss your treatment goals. Your dentist will use a shade guide to select the composite resin color that matches the color, of the tooth or teeth, most closely. Once your dentist has chosen the color, he or she will slightly etch the surface of the tooth to roughen it. The tooth will then be coated lightly with a conditioning liquid, which helps the bonding material adhere. When the tooth is prepared, your dentist will apply the tooth-colored, putty-like resin. The resin is molded and smoothed until it's the proper shape. Then the material is hardened with an ultraviolet light or laser. After the bonding material hardens, your dentist will further trim and shape it, and polish the material until it matches the sheen of the rest of the tooth surface.
Dental veneers are a shell or layer of tooth-colored porcelain placed over the facial surfaces of teeth to correct worn tooth enamel, uneven tooth alignment or spacing, discoloration, and chips or cracks. Although dental veneers fall into the category of cosmetic dentistry (because they create bright, white smiles with beautifully aligned, shapely teeth), they also protect the surface of damaged teeth and may eliminate the need for more extensive treatments. Other benefits of veneers include durability, an improved smile appearance and the need for little-to-no removal of tooth structure compared to crowns.
Porcelain is the most appropriate and long lasting material for dental veneers. The removal of any natural tooth structure is permanent, so dentists today prefer to offer patients the most minimally invasive options first. If your natural teeth are functionally and esthetically adequate, dental veneers may not be an appropriate treatment for you. Veneers do have the added benefits of longevity and a proven ability to enhance the appearance of the mouth, smile and other facial features that are better supported by properly shaped teeth.
Porcelain dental veneers may require the "shaping" or "prepping" of all teeth being treated. Therefore, some cosmetic dentists first recommend teeth whitening to people with mildly discolored teeth who want a whiter smile because it’s the least invasive cosmetic dentistry option . If crooked teeth or alignment issues are involved, whitening also may be combined with orthodontic treatments. To get your customized treatment plan on how you can achieve a flawlessly beautiful smile, schedule your consultation today!
Teeth whitening is a popular procedure to make your teeth whiter and brighter, and therefore more attractive. Bleaching can be used to whiten stained and discolored teeth, or simply to enhance a dull smile. Either way, teeth whitening is a safe and relatively painless procedure for most patients. Whitening comes in strips, trays, or in-office procedures. We offer a wide variety of options for you at our practice.
In-office bleaching procedures are ideal if you want immediate results. The whole process takes about an hour, taking little time out of busy lives. A protective gel is applied to your gums to protect the soft tissue. Then a special light-activated gel is applied to your teeth and light or laser is used to enhance the action of the agent. Finally, the patient receives a take-home gel and instructions to keep the smile bright. The result is dramatically whiter teeth that will last for years.
Take home tray whitening is a less-expensive and convenient at-home whitening treatment. The results are more gradual. An impression is taken at the dentist's office in order to create a customized clear tray. Trays are generally ready within a few days, depending, and the patient must follow instructions for how to apply the gel in the trays and how often to use it. Maximum whitening results and a dazzling smile are achieved at the end of the set treatment period. An occasional treatment can be used to maintain the new smile.
Whitening strips can be available at the local store or at dental practices. Your dentist will have the best recommendations for your needs. Ask about our whitening options! Please consult us about use of over-the-counter whitening treatments.
Clear Tray Orthodontics
Clear aligners are an attractive alternative to traditional metal braces. It is a series of clear, custom-fit removable mouth trays that apply a controlled amount of force to your teeth to slowly straighten them. The system provides the same beautiful results as traditional braces, but they are virtually invisible. Because clear aligner trays are removable, they can be taken out while eating, drinking, brushing and flossing.
The system begins in the dentist or orthodontist's office with taking molds to design a your trays. Patients switch trays every few weeks to gradually shift the teeth. The system requires a visit to the office every six weeks so that treatment can be monitored. Once treatment is complete, a patient will likely be given a retainer to maintain the smile. The cost of clear aligners varies according to the complexity of the case. Insurance policies generally cover clear aligners to the same extent that they cover traditional braces. Contact us to see if clear aligner orthodontics is a good solution for you.
Pediatric (Kids) Dentistry
We offer compassionate and comfortable children's dental care in a friendly, caring environment - we love seeing children of all ages! A fun dentist visit for your child and an informative visit for you is our goal in building a lasting relationship with your family. We want your child to have lots of healthy, happy smiles and a lifetime of good oral heath! Our well-trained, courteous and professional staff will make you and your child feel at ease at their next dentist visit. Plus, a play area and treasure chest visit will keep your child wanting to come back to the dentist, again and again! Dr. Mindy has been practicing pediatric dentistry and putting children at ease for years. She uses the most advanced technological procedures available to ensure the health, safety and well-being of your child. Morning, evening and even Saturday appointments are available to conveniently work with your family's busy schedule!
The loss of a single tooth can have major impact on overall oral health and appearance. Although dentists will use every measure to prevent tooth loss, there are still some occasions when a tooth needs to be extracted. The dentist may suggest an extraction after careful examination and treatment — usually taking x-rays to understand the shape and position of the tooth and surrounding bone before extracting the tooth. Based on the degree of difficulty, a dentist may refer you to an oral surgeon. A certain amount of pain and discomfort is to be expected following an extraction, but it can be minimized with pain killers and ice packs applied to the face for 15 minutes at a time. Discomfort should lessen within three days to two weeks. If you experience prolonged or severe pain, swelling, bleeding or fever, call our office immediately (818) 532-2977.
Root Canal Therapy
Root canal treatment, also referred to as root canal therapy or endodontic therapy, is used to save an infected or damaged tooth and avoid having to remove it. A root canal becomes necessary when a neglected cavity reaches all the way to the pulp at the center of the tooth, causing the pulp to become infected. Regular cleanings and checkups detect and prevent problems early on. Trauma can also cause deep damage to the nerve of a tooth. Once this occurs, the pulp becomes infected, and it begins to eat away at the surrounding bone (this is called an abscess). By the time the pulp is infected it must be treated, and cannot heal on its own. It can even weaken the entire immune system, making it very dangerous and painful. Symptoms of infected pulp may include sensitivity to hot/cold or sweets, pain, swelling, pain with biting or pressure, and a bad taste in the mouth. Sometimes, however, there are no symptoms, and you are unaware of any problem until a checkup. A root canal is performed to clean out the infected tooth pulp and disinfect the canals of the tooth. The only other treatment would be to extract the tooth. Once the infection is resolved, the canal(s) is filled to prevent any further infection. Crowns are usually recommended to cover and restore a tooth after root canal therapy.
Custom-designed mouth guards and night guards are made of flexible plastic and molded to fit the shape of your teeth. Mouth guards are recommended to protect the jaw, tongue, cheek lining and teeth during physical activity and sports such as boxing, football, basketball, or other activities where your mouth might get hit. Night guards are recommended for patients who clench or grind their teeth at night to protect their teeth. Guards generally last 3-10 years.
Custom-made oral appliances can also be used as part of treatment for conditions like sleep apnea and TMJ disorders. In general, plastic appliances can be used to correct a variety of problems. If you are active in athletics or experiencing any concerning experiences with your mouth, teeth, or jaw, please let us know. If any kind of guard or appliance is a good option for you, we will take an impression of your teeth to create a custom-fit product for your specific needs.
Accepted Insurance and Finance Options
As a courtesy to our patients, we are in-network with most major insurance companies, such as Aetna, Anthem Blue Cross, Assurant/Sun Life Financial, Cigna, Delta Dental, Guardian and MetLife. Our Office Manager has been a member of the American Dental Coders Association for several years and knows the "ins and outs" of dental insurance, as well as the pros and cons to each dental insurance plan specifics. If you have insurance and would like more information about your coverage, or are interested in obtaining insurance but have some questions from someone who isn't trying to sell you the plans, give Melody a call (818) 532-2977!
We also accept payments by cash, check, Visa, Mastercard, Discover and American Express. To help with larger treatment plans or to help make completing treatment more affordable, we offer financing through Care Credit, which offers payment plans such as interest-free financing for six months or for or larger treatment plans, Care Credit offers extended plans that can go out as far as sixty (60) months. To learn more about Care Credit financing or to apply online, click here.