Video Learning Library

Learn about procedures, FAQ’s, and how Atlanta Dental Spa’s attention to smile details benefits you!

General Videos

Smiles Can Transform the Soul

At the end of my life, I want to look back and know that I mattered–that I mattered to my friends, my family, and my patients. I wasn’t blessed as the fastest runner, the strongest person in the world, the tallest, but I was blessed with the ability to transform smiles.

Our faces have two really important features, in my opinion: your eyes and your smile. We have the ability to change our smile, and through the power of a smile, I’ve seen miraculous things happen. I’ve seen patients walk in that could hardly look me in the eyes prior to doing their work, and then months later, after performing the smile of their dreams, I’ve seen them come in with a whole new different personality, really, whole new confidence level. And that’s where I look and say, “Wow, I’m really blessed to provide this impact in this person’s life.” Smiles can transform the soul. I truly believe that. It can allow the person to become the true person they were destined for, without any psychological barriers holding them back. One of my favorite quotes is by John Lennon, who says, “Measure your life by smiles, not tears.” And I’m glad to be able to play a part in some of that.

Top 16 Reasons to Choose Atlanta Dental Spa
Here are the top 16 reasons to choose Atlanta Dental Spa. #1: Atlanta Dental Spa is a complete health dentistry. We believe that the mouth is connected to the body, and we practice that way. So through your time here, you may see the correlation in why we recommend certain #2: We’re a relationship-based dental practice. Many people comment on how friendly we are or enjoy seeing the same faces. And really, we do pride ourselves on getting to know each member of our dental family. #3: We’re not corporately owned. There’s been a big takeover recently in dentistry where corporate investors have been taking over practices, and that destroys the relationship-based practice of number two. #4: We do offer warranties, and we have amazing customer service as you’ll see becoming a patient. #5: We have two convenient locations, one in Buckhead, for inside the perimeter, and the second one being in Alpharetta-Roswell area for outside the perimeter people. #6: Obviously, you’ve probably seen by now that we’re top-rated and top reviewed. And we pride ourselves on that. We try and treat all of our patients as family. And of course, they proclaim or sing our praises online. So we really are happy with the fact that we are top-reviewed and top-rated. #7: Our doctors are world-class. We have tons of awards and reviews and accolades and fellowships and all sorts of stuff. And you can read about that. But we’re definitely qualified to provide excellent care for you. #8: We have a team of masters. You may have seen the video of Dr. Currie and Dr. Creasman talking about how we have an approach where we’re masters at certain things that we do in the practice. Whereas, there may be cosmetic dentistry and masters at implant dentistry and masters at just restorative dentistry. But we got a team of masters under one company. #9: We do a lot of in-house procedures, kind of what I just spoke about is that we can keep a lot of stuff in-house versus ping-ponging you around to various locations for a root canal or extraction. And having to go to all these different places, you may not be comfortable with that, meaning a whole new set of paperwork and a whole new set of doctors and a whole new set of front desk people. People enjoy having things in one house because you see the same faces. And once you’re comfortable in dentistry, which we know is sometimes rare, you get to stay at the same place. #10: We have awesome technology, from CT scans to even the technology that makes you comfortable, noise-canceling headphones, TVs in the ceiling, even just the technology of the layout. I designed this office that I’m in right now, the Buckhead office, that actually has no sharp corners because sharp is associated to things that we may not like. So it’s all the little minutia that really adds up to the experience of Atlanta Dental Spa. #11: We are the Atlanta Dental Spa. We’re often imitated. You may see dental spa here and there, people trying to become us. But we are the real deal, from the layout, from the design, from just the spa whole, overall feeling. #12: We value your time, and this is huge. I really am proud of this fact is that if you have an appointment at 10:30, we will see you at 10:30, right? Many people complain that “Oh, I showed up for my appointment on time, and they didn’t see me for an hour and a half.” Time is important. It’s important to all of us. And we take that very seriously. #13: Entertainment options, so we know that you don’t love coming to the dentist. So while you’re here, we’re going to give you some options to help pass the time. We have TVs, like I said, in the ceiling. When you’re laying back, you can watch your favorite channel. There’s over 200 channels of high-def programming. There’s movie options. Even music options we can give you while you’re here with us. #14: We have an open and visible sterilization area. Recently, there’s been topics on the news where protocols haven’t been followed, and some people have gotten sick. There was an office in Oklahoma where they weren’t effectively sterilizing equipment. Not a big topic until it is one. So our sterilization is open, not behind closed doors, because we are proud of the fact that we have the most modern sterilization techniques, which is super important in today’s age. #15: We have authentic before and after images. Every picture that you see on our site is our dentistry. Believe it or not, you can actually buy clip art images. And a lot of dentist websites will actually have bought stock images that they put on their website. It’s not even their dentistry. To me, that’s embarrassing. So every picture that’s on our site is our dentistry. #16: It’s the golden rule, treat people how you want to be treated, and that’s how we run our business. That’s how we run our practice. The full list in greater detail is here: atlantadentalspa.com/why-choose-us.html

Top 16 Reasons to Choose Atlanta Dental Spa

Dr. Creasman: One of the things that makes Atlanta Dental Spa different from every other place that you go is just that we have so many capabilities under one roof. We have surgeons who can take care of your needs. We have restorative dentists and cosmetic dentists who can make everything look beautiful. It’s just we don’t have to send you out like you do in many other dental offices to go see this guy for one thing and that guy for another. And hopefully, everyone all talks. The nice thing about Atlanta Dental Spa is you’re sitting in the room with everybody, and we’re all on the same sheet of music, and we’re all focused on where your care needs to be.

Dr. Currie: I think you hit the nail on the head there. It’s really important if you’re having a lot of work done that whoever is working on your smile, it’s making sure that everybody there is on the same page and understands the goal and is working together. And I think it’s a really awesome thing for us to offer to patients to where every day when you’re here in our chair, you’re not getting my opinion. You’re not getting Dr. Creasman’s opinion or Dr. Boulden’s opinion. You’re getting all of our opinions and all of our heads working together every time to come up with the perfect treatment plan for your scenario. And then instead of having to ping-pong around town to get a root canal here, an implant there, an extraction there, veneers here, we do it all here. And we do it together. Dr. Creasman: Right. Dr. Currie: A lot of times we’ll plan on doing a really long day where we just go to sleep, which is another great thing that we offer here. We offer IV sedation. And you get all your surgery taken care of and then wake up with a new set of veneers or a new set of temporaries. You can have an enormous transformation in one day, in one place, with all the minds working together, doing it right. Dr. Creasman: Right. Dr. Currie: In a surgery, sometimes you’re put in a position where you think it’s gonna be an ideal scenario. But when you get in there, you gotta think on your feet. Everything changes when you actually look at what bone there is for an implant per se. And so the surgeon has to make a judgment call there. In most scenarios, that surgeon is doing it by himself, and he has to do what he thinks is best. In our scenario, I can hit the pause button, have Dr. Creasman step in and say, “Yeah, if you put the implant there, I can still make that look exactly like I want it to. Go for it.” Or “You know what? To do it right, we’re gonna have to graft it and put it where it needs to be when it’s ready.” And that’s the way you want your surgery done. That’s the way you want your dentistry done. Dr. Creasman: Right. Dr. Currie: You want everybody working together and doing it right.

Commitment to Excellence
At Atlanta Dental Spa our commitment is that every person in every position strives to be the very best at what they do. It’s through this commitment to excellence that we’re able to provide you with cutting edge care and the best environment, so that you can have an experience like no other.    

What is Minimally Invasive Dentistry?

Dr. Boulden: At Atlanta Dental Spa, we truly believe that less is more. We’d like to drill on the tooth less and achieve the same result. Dr. Creasman, I think the coolest advancements in modern dentistry, and especially the way we do things here, is the fact that we’re allowed to be minimally invasive. I mean, what do you think of it, recently has been some of the cool advancements in dentistry?

Dr. Creasman: Oh, absolutely. Minimally invasive dentistry is a win for everybody. It’s conserving your tooth and letting us rebuild Mother Nature only where it needs to be. We have all types of options available, whether it be a no-prep veneer or very conservative composites, inlays as opposed to crowns which allow us to keep the healthy part of the tooth without grinding it all down or even doing something like caries reversal, where we prescribe rinses to help repair the damage at a very early stage. I think it’s just a great way to treat our patients the way we want to be treated.

Dr. Boulden: Wouldn’t you agree it used to be either there was a filling or a crown?

Dr. Creasman: Oh, absolutely.

Dr. Boulden: The old school way, and now it’s become a thing where we have all of these options in between, which is just a benefit to the patient.

Dr. Creasman: Well, the technologies allow us to be more conservative and have more options. You’re right. Years ago, we could do a little damage or a lot of damage, or actually, there was a lot of damage or a lot more damage. Now we don’t have to do that. Now we can just fix teeth and keep them the way they’re supposed to be.

Our Core Philosophies
Welcome to Atlanta Dental Spa. Ten years ago, this company was founded with you in mind. I built this practice based on two core philosophies. I wanted to build the most beautiful, pampering environment possible with noise cancelling headphones and aromatherapy, things that take you away from that previous dental experience you might have had. And the second, was I wanted to provide the most amazing dental result possible, meaning the highest level of care possible in dentistry. I’m very proud of the team we’ve assembled here, and I know that you will be pleased as you become a patient of our practice as well. I look forward to meeting you soon.

Advice for Pre-Visit Pain Control

Are you in pain right now? Is your tooth hurting? Did you just have any kind of surgery or procedure done? Pay attention, because we used to be able to call the pharmacy and say, “Hey, I’m gonna need my patient to come by and pick up a pain pill prescription.” We can’t do that anymore. They have changed the laws so we can no longer call in pain medications. You have to physically come from our office with a unique piece of paper that allows for that.

So what do you do if it’s over the weekend at night? What if it’s not bad enough to need pain pills but you need some help, and Advil’s just not cutting it? Well, here’s some easy over-the-counter pain control instructions that you can do at home, that you can get from any pharmacy or grocery store out there. So the first thing is, if you have kidney problems or if you have liver problems, please take note that these instructions do not apply to you because Ibuprofen, which is also known as Advil or Motrin, that is a kidney-metabolized drug. Tylenol is a liver metabolized-drug. So if you have problems with either of those organs, don’t do this. Also, if you’re taking Tylenol, you cannot take alcohol or drink alcohol at the same time. It’s really, really dangerous. The leading cause of acute liver failure is somebody taking Tylenol after a hangover or while they’re drinking. So be careful with that, okay? The quick rundown is, if you’re just hurting, Ibuprofen or Advil, 400 milligrams. That’s two pills from your normal over-the-counter bottle. That’s all you need. But what if you actually just had a procedure done where there may be some swelling involved? You’re actually having swelling, and you haven’t gotten treatment yet. That needs 600 milligrams to actually be effective. So that’s three pills from the normal Advil or Ibuprofen bottle. That’s every six hours. The easy way to remember Ibuprofen is 400 every 4 hours, 600 every 6 hours, and you can do 800 every 8 hours. Eight hundred every eight hours is great if you’re going to bed or something, where you know you won’t be able to re-dose pretty soon. But it doesn’t do anything more effective than the 600. So the people that come and tell me, “I’ve been taking 15 Advil every day,” kind of thing, be careful. You’re probably overdoing it, and it’s not an actual effective way to take it. What you really wanna do is take the 600 milligrams of Ibuprofen every six hours. Three hours into that, take a dose of Tylenol. And when I say a dose of Tylenol, I’m not telling you milligrams right now because I don’t know what Tylenol bottle you have at home. Tylenol comes in different forms. Read the bottle and take it as directed on the bottle. So do whatever it says on the bottle and stagger them. So you’re taking your Ibuprofen. Then two to three hours later, you take that dose of Tylenol. Two to three hours later, you’re due for your ibuprofen. Two to three hours later, you’re due for your Tylenol. They have a synergistic effect. That means when they’re both in your system at the same time, they’re much more powerful than just the two of them combined. It’s actually about as pain-killing as effective as codeine, which people don’t really perceive because you’re not having that painkiller feeling. You’re not getting any drowsiness or buzz or anything like that. But it’s super, super effective. If you’re hurting, make sure to stagger them, make sure to read the label so you’re taking them safely, and you can get a lot of relief from this.

There Is A Difference
When you walk into Atlanta Dental Spa, you immediately know you’re someplace different. You’re greeted with smiling faces that welcome you into a great environment. With Spa-like amenities, we create a relaxing environment that makes you feel like you’re at home.

What is a Dental Spa?

We’re often asked, “What is a dental spa? Is it a place where I go get a massage?” Well, of course not. That’s not what we do. But the intent is the same. The intent is to give you a relaxing environment in which you can have your care provided.

I mean, let’s be honest, no one likes going to the dentist. We know that there’s a hundred things you’d probably rather do. People love going to the spa, because it’s a great experience. Well, that’s what we try to do. Through the use of amenities and a relaxing environment, TVs on the ceiling, we get rid of all those awful dental smells that you associate with. Relaxing environment, noise cancelling headphones. We just create an environment that takes your mind off of what you’re doing, makes it a pleasant experience, and really let’s you be as comfortable as you can while you come in, and have a great experience.

FAQ’s

What's the Best Toothpaste for Me?

 So if you’ve been to your local pharmacy or grocery store, and walked down the toothpaste aisle lately, you’ve seen there are about a million choices. I get this common question from people all the time like, “What toothpaste is the best? Which one do you use?” And really, for me, it boils down to two things, the abrasiveness of the toothpaste and really its flavor and taste. Those are two kind of personal preferences.

I like to recommend an Arm and Hammer product for people mainly from the fact that it’s baking soda, and you would think that that would be very abrasive. So many people think that baking soda is abrasive, but it’s really not. It’s really one of the least abrasive toothpastes. So for my veneer patients, I say, “Do not use a whitening toothpaste.” That’s a common question they ask when we’re all done, their smile designed is, “What toothpaste should I use now?” and I personally use an Arm and Hammer because it’s not very abrasive. The reason I say that is because porcelain veneers actually have a coating on them. It’s a glaze that when they come back from the lab, that’s what protects them from being very stain-resistant. Overtime if you use a whitening toothpaste, the way whitening toothpastes work is actually abrade a layer of tooth structure away. So it’s kind of like shining a new layer off. So microscopically every time you use this whitening toothpaste, it abrades a new layer of tooth and all of a sudden it’s whitening but you don’t need that with porcelain veneers. So stay away from whitening toothpastes especially if you have veneers. In general, if you want to whiten your teeth, don’t do it with a whitening paste. Do it with a whitening product. Come in, get fit for custom trays or actually do the in-office power whitening. That’s really the way to whiten your teeth, but stay away from whitening toothpastes in general. There’s a chart on this page that actually shows the abrasiveness of a lot of the common toothpastes, so look at that. And in general, the more general you can be with a tooth, the better off you’re going to be. You can view the chart showing abrasivity of common toothpaste brands here: atlantadentalspa.com/best-toothpaste.html

I see a black line on some people's gums, what is that?

Dr. Boulden: All right. So I’ve got a question for you that I get asked almost every day from patients. They say, “What is that black line that I see in people’s dentistry around the gum line?” Can you explain that?

Dr. Creasman: Sure. That black line is actually old technology. What that black line is, is years ago we had to put metal under a lot of the dental work, which we don’t do anymore. But that metal, you can’t mask that out. So they would try to bury the margin of that black line as deep under the gums as they could. Well, the gums didn’t like that, and eventually they start to recede. It exposes that black line, and there’s nothing you can do except for remove that restoration. Now the good thing is, is that we’ve got options that just don’t require us to use that type of dentistry anymore. It’s old technology, and we don’t have to use the metal that we did in the past. So we don’t get black lines in our restorations. Our crowns and our veneers and all of our restorations look beautiful and natural and lifelike. Dr. Boulden: And metal-free.

What Does That Blue Light Do?
One of the most common questions I get in dentistry has absolutely nothing to do with teeth. It’s “What does that blue light do?” Well, the blue light is actually a magic wand, the only we have. All right, but it does allow us to transform smiles. The blue light actually allows the dental materials that we have to set hard. So if we are able to sculpt some composite onto a tooth, that blue light that sounds like more a hair dryer, it actually makes the materials set, and allows us to create beautiful dentistry.    

Veneers

Veneers 101

Dr. Boulden: So between the two of us sitting here, we’ve probably done about 20,000 veneers in our career. Wouldn’t you agree?

Dr. Creasman: Probably. Dr. Boulden: So I want to have a little discussion. Let’s do a veneers 101, just some of the general questions that people ask in a very concise manner. Maybe starting off with exactly what they are. Dr. Creasman: Sure, sure. Often it’s like people don’t even really understand what a porcelain veneer is. Well, a porcelain veneer is a thin facing of porcelain that is applied to the front of the teeth that allow us to change the things about our smile that we don’t like–whether it’s the color, the shape, the size, maybe you have a gap, or maybe they’re crowded. But it allows us to change the appearance of the tooth. Dr. Boulden: Almost like a contact lens you can put on the front and change the color, the shape, the contours, that kind of thing. Another question I get a lot from people is, well, how much do they cost? And sometimes people get sticker shock quite honestly when they see the cost of a veneer. The cost of a good veneer in our practice is around $1500, and that’s when people say, “Whoa, each tooth?” But what they don’t realize is that you get what you pay for. Yes, there’s people around that are offering $800 veneers, but I can’t tell you how many times I’ve taken off an $800 veneer. You can probably say the same. Dr. Creasman: Exactly. Dr. Boulden: So our veneers are done by a master ceramist, done by a master dentist who have done this all day every day. And so just like anything else in life, you really do get what you pay for. The time length for the whole process, I get that question a lot. Dr. Creasman: Right, every day. Dr. Boulden: And that can vary, but it’s roughly three appointments. Would you agree? One’s a consultation, sometimes a wax up. Dr. Creasman: Right. Generally start to finish, it takes about four weeks to do a case. And that is from the time we sit down and we start talking to the time you walk out with a beautiful new smile. Dr. Boulden: Agree.

How Long Do Veneers Last?

So veneers last between 15 to 20 years. That’s typically what we tell people when we’re placing them. One question I get immediately after that is, “Well, what happens after that 15 to 20 year period?” And essentially your tooth doesn’t fall apart, they don’t just spontaneously break or crumble away. Essentially what it just needs to be is the margin around the tooth of where it attaches, it starts to degrade. We gave you the contact lens analogy. Almost like you can think about the periphery around that lens has become degradated and is now leaking.

So all we have to do now is just take off that old veneer and replace it with a new veneer on a new bonded interface. So to answer the question of how many times you could have your veneers replaced, really unlimited amount of times, because it can be a very conservative replacement process.

Are Veneers Covered by Insurance?
Typically, veneers are not covered by insurance. I get that question a lot. Insurance is usually in place to help fix things that are broken or damaged. Veneers typically are cosmetic. There is an exception to that when insurance can actually kick into the play is when the tooth previously had a crown or large filling that’s now faulty. Now we can replace it with the modern advantage of all porcelain veneer or something, and it can be part of the components of doing your smile. So lots of times I tell patients, “No, your veneers are not going to be covered as a whole. But there may be one or two teeth that do qualify for insurance coverage. But overall it’s elective care.”

Being Conservative With Your Smile

Being conservative in dentistry is truly an art form. Believe it or not, one of the easiest things to do in dentistry is make a bunch of crowns for when you’re doing cosmetic dentistry. That’s also one of the biggest problems that I find is that people’s teeth have been needlessly reduced, and you see the terms on the Internet like nubs. Or they made shark teeth out of you.

Honestly, that doesn’t have to be done anymore. The materials we have now are a lot stronger. And it allows us to be a lot more conservative. So honestly, being very conservative in dentistry is a lot more technically challenging than just doing something that looks like it might be complex. So the way we do it at Atlanta Dental Spa to remain conservative and ensure that we’re preserving as much tooth structure for you as possible is actually doing a couple of things. Number one, the first process before we do any dental treatment is actually to take impressions of where you’re starting with, impressions of your teeth. So imagine this was a before model of your teeth, okay? With this model, now you and I will communicate on the goals in which we want to do, meaning the shape, the length, all the contours we want to replace, basically, all the fixes we want to do. I’ll communicate that to my ceramist who will then deliver what’s called a diagnostic wax-up, okay? So this is all done before any dentistry has been done on you. So imagine if we were building a house, this would be like the blueprint for what we are going to build, okay? So a lot of offices don’t really do it this way. But we do a lot of steps on the front end to make sure there’s success when we get to the end. So here we have the wax-up, which is essentially our blueprint. And now, from that wax-up, I actually will have a guide the day I do the procedure. I’ll actually have a guide that’ll allow me to show exactly what to reduce and where to reduce so that I’m not removing too much and I’m reducing areas that need to reduce to ensure that we have a perfect aesthetic result. So it’s very, very regimented the way I do things. And sometimes people get frustrated with the process and the complexity of making sure they’re getting the right results. But in the end, it’s all based for getting the perfect result with the minimum amount of reduction all for you.

Caring For Your Dental Temporaries
Dr. Boulden: When you get your dental temporaries, one thing that may be a little shocking is the fact that they’re all connected from side to side. When I had temp veneers done on my own teeth, it was a little foreign feeling to have this. I don’t want to say a wall of teeth because that sounds like it wouldn’t look good, because the temps looked awesome, but they were all connected. I wasn’t able to floss in between my teeth. Nor do any of our patients have that ability. So one of the things that’s important when you’re in your dental temporary phase is to make sure that you’re keeping things clean because you won’t have the ability in that three-week period to floss. What are some good tips that you have to helping keep things clean in that phase? Dr. Creasman: Well, there are several things that we do to help you maximize your home care. Yes, there’s strength in numbers which is why they’re all hooked together, but it does make home care a little more challenging. There are some things that we absolutely will prescribe for you, which is rinsing with hydrogen peroxide. That allows you to get into the nooks and crannies where your toothbrush can’t get and where the floss would have normally gone. Dr. Boulden: I did that about five times a day with mine. The more the better. The more irrigating you can get through because things kind of get trapped. The more you can irrigate and get that food and debris and stuff out from between your teeth, the better. Dr. Creasman: Absolutely. Helps control bad breath and things like that because the bacteria can get up there if you don’t keep it clean. Dr. Boulden: What about staining? What are some tips you think for preventing staining? Because they are acrylic, I think they stain versus…the total opposite is porcelain can’t stain, and we get it for the final product. So dental staining on the temporary can sometimes be a problem. Dr. Creasman: Absolutely. The most common question is, “Does that mean I can’t go to Starbucks?” Well, no, of course not. Temporaries will stain, and you just have to be aware of that. But that doesn’t mean you can’t have all the things that you enjoy normally like coffees and things like that. You do have to drink them through a straw. Now once the final restorations are in, you can go back to normal, but with the temporaries, anything that introduces stain will stain them. So I always use the rule that if you dropped it on a white shirt and it left a stain, it’s going to stain your temporaries, too.

No-Prep Veneers Explained
Everyone’s heard of Lumineers. Lumineers are just a brand name for no-prep veneers. No-prep veneers are a great way to allow us to change our smile and be very conservative. It’s really business-card pieces of porcelain that are very thin–look how thin that is–that we apply to the front of the teeth that allow us to do the things that all veneers do, which is change color, shape, things like that. The major benefit to a No-prep veneer is that it allows us to be very conservative, and we don’t have to do a lot of dentistry to get that beautiful result. Now, while that may sound like it’s really easy, it is, but it does require a skill level. Not everybody’s a candidate for No-prep veneers, and that’s where we come in. That’s our area of expertise. We can evaluate if you’re a good candidate for something like a no-prep veneer, and even if you’re not a candidate for no-prep veneer, we may be able to do a hybrid technique, which is where maybe you have one tooth that we need to gently reshape, but the rest of the teeth are perfect candidates. So we can still stay very conservative, get a beautiful smile, and make it look as great as we can.

Components of a Great Smile

Everybody’s heard of a ‘million dollar smile.’ Well how do we do that? What are the components that make a million dollar smile? Well, there are several things.

Obviously, the teeth have to be pretty. They need to be uniform in color, and uniform in color doesn’t mean one color, but they need to all blend in. Real teeth have many different colors in them and that’s what makes a real veneer or our real tooth look natural as compared to some of these Chiclets that you’ve seen that don’t look nice.

The other thing that we do is we make sure that the teeth are aligned properly, the angulations of the teeth have to be in symmetry with each other, because if one tooth is out of alignment it becomes the focal point of the smile instead of just the smile being pretty.

Obviously symmetry is important as well. No one tooth should stand out, everything needs to look like a matched set. The teeth need to be complementary to the face and look like they’ve always been there. So making sure that the teeth are balanced and match the rest of you is what really makes a million dollar smile.

Are Veneers Painful?

So you’ve decided that you want the million dollar smile, and you think veneers are the way to go. Well, one question that people ask when they are on the process of finding out things about veneers is “Are they painful?” And honestly the answer is no, yes, or maybe. That seems to be kind of a convoluted answer, but the amount veneers can be painful, honestly, based on the amount of reduction to the tooth. It’s usually proportional to that, and what I mean by that is if you find someone who wants to make crown preps everywhere and do a lot of destruction to the tooth, then yeah, potentially it could be a little bit painful.

At Atlanta Dental Spa, we pride ourselves on being as conservative as possible, most of the time staying all within the enamel of the tooth. The enamel, believe it or not, does not have any triggers of sensitivity so we just don’t have complaints of saying, “Oh, my veneers are sensitive” or “My teeth are sensitive after veneers.” It usually just isn’t a problem. Again being conservative, it benefits you on a whole lot of levels: teeth not being sensitive, you’re preserving all your natural enamel, things like that. So really it pays to do your due diligence when looking to find someone who is gonna change your smile, and it’s an important thing because smiles are noticed just as much as your eyes. There’s actually a study done that said, “Which is the most important facial feature?” The study came back literally 50/50 that it’s either your eyes or your smile. We really don’t have the power to change our eyes so much, but we do have the power to change our smile, so it’s important to choose wisely.

Will My Veneers Look Fake?

A common question I get from people are common detriment I think from people getting porcelain veneers is they say, “Oh, I’ve seen veneers and, oh, they look fake.” And my response back to them is, “Well, of course you’ve seen the bad stuff because that’s the stuff that looks unnatural.”

Usually one of the big qualities of a veneer looking unnatural is a couple of reasons. Number one, they’re too bulky. So you see these teeth coming into the room before the person enters, and that could be done because they were prepared wrong by the dentist or they were done by a poor lap. But awesome veneers should just look like an awesome smile, not veneers at all, and so you shouldn’t be able to detect them. So going back to what people in the consultation is, “Oh, I’ve seen veneers.” Well, of course you have. You’ve seen the bad stuff because it just jumps out of you. It looks unnatural. So the goal of modern cosmetic dentistry is to replace and mimic nature as perfectly as possible. So we spend a lot of time making sure that we mimic that using master ceramist, using the latest techniques in creating veneers that blend with your face, so that it is not noticed and people say, “Wow, you have such an awesome smile.”

How to Take Care of Your Veneers
So you just got the million-dollar smile. Now I’m going to answer some questions on how you take care of it. The million-dollar smile, probably in this office, was done via porcelain veneers. Here are some tips of ways to kind of preserve that look. Again, if you haven’t watched the toothpaste video that I talk about, I encourage you to go look at that video because it talks about how to preserve the glaze on the porcelain. The longer you can preserve that glaze, the longer the porcelain will look and have that luster and sparkle that you walked out with the day you got them. Veneers, essentially, you are going to treat the same way you do natural teeth. You’re going to brush, floss them as normal, using a rinse. They are meant to be an improvement to your life, not an impediment. So you can still eat the corn on the cab, you can still eat the apples. If you’re an ice chewer, probably not a good idea in general. Not only that you have veneers but your natural teeth, it is probably not a good idea. So just using common sense to preserve your veneers will make them last a long, long time.

Dental Temporaries: Facts, Strength, Purpose

Dr. Boulden: One thing that I think is important to talk about today is really the strength of the dental temporaries. As we already said in an earlier segment that they’re kind of daisy chained together, all connected, and that’s for a strength reason. Because they’re not bonded on, we have to preserve that bonded interface, from when we do the veneers. But sometimes, some of my patients get a little paranoid when they will break a temporary or two, right?

Dr. Creasman: Sure, sure. Dr. Boulden: And they one day ask me, “Is this gonna happen in my permanents?” Maybe you can talk about the strength versus acrylic versus porcelain and maybe give some people who are either in temporaries right now, or considering the process, a little comfort. Dr. Creasman: Sure, absolutely. Well, we call them temporaries for a reason. They’re not meant to hold up to the rigors of chewing long-term. They’re really meant to do the things that we’ve talked about in the other segments, which is act as a communication tool and some things like that. The temporaries are made out of an acrylic material, not porcelain. The acrylic only has a fraction of the strength that either your tooth or real porcelain does. Also, the fact that we don’t adhere them permanently to the tooth is the reason that we see that there is sometimes some breakage. If you break a temporary, don’t panic. It’s not the end of the world. Dr. Boulden: It’s no big deal. Dr. Creasman: It’s just part of the process that we go through, especially if we’ve made a lot of changes to your smile. You’re acclimating to the new shape or the new length, so maybe you bump into them. Dr. Boulden: That’s good. Dr. Creasman: You’ll adapt to that, but the temporaries, they are just weaker, so don’t be concerned if you have a temporary come off. We can fix that, but that’s not representative of what you should expect with your final veneers.

What to Expect with Temporaries
Dr. Boulden: Dr. Creasman, we spend a lot of time on our temporaries. Dr. Creasman: Yes. Dr. Boulden: And I get a lot of feedback from patients who are going through that. No one really loves the temporary process because of the way they feel. Dr. Creasman: Sure. Dr. Boulden: And you agree with that? Dr. Creasman: Absolutely. Dr. Boulden: They don’t actually feel like the permanents are going to feel. I can remember when I actually had temporaries in my mouth. The first thing I thought was “Oh my gosh, is this what veneers are going to feel like?” And it really almost freaked me out for a while. Luckily, when I got my permanent veneers, they felt super smooth and actually better than my natural teeth when I finally got my veneers put on, the veneers that you did for me, as matter of fact. Thank you. Dr. Creasman: You’re welcome. Dr. Boulden: But let’s talk about the temporaries, and this is one of the questions we might have regarding that. Number one, how do they feel? Dr. Creasman: Well, dental temporaries, like you’ve just said, they don’t feel like the final result, but they are a good representation of what the final teeth are going to feel and look like. Dr. Boulden: So they’re made of a base acrylic which is really just an acrylic. An acrylic is more porous versus porcelain is more shiny, so they look really good. Our temporaries look awesome, they look really good, but they don’t feel… Dr. Creasman: They’re going to feel a little more rough. Dr. Boulden: Right. Dr. Creasman: And that’s just a temporary thing, it’s a short term thing, but given the material that we have to make it out of, it’s just not going to be quite smooth. So when the final restorations go on, everything’s going to feel like crystal smooth glass. Dr. Boulden: I know one question that I get and people ask is why do I have to wait so long in these temporaries? And a good explanation for that is that high-end elite level dentistry takes a long time to make. There’s a lot of process from the day that we do the first procedure, which is actually preparing the teeth for veneers, and then actually sending that off to our master ceramists. There’s a lot of work that goes into creating your artwork. Do you get that question a lot? Why so long?. Dr. Creasman: Well, sure, let’s face it. No one wants to be in that phase. The temporaries are a short process, but when you’re in it, it can seem like an eternity. We understand that. It’s really not. The reason it takes so long is there’s two things that happen. First of all, behind the scenes, the ceramist is creating beautiful porcelain veneers that are going to just knock your socks off. But it’s also the ability for us to create and communicate what your desires are. We can look at pictures and photos and things like that, but until you actually have them in your mouth and see them and let us look at them, we can’t really communicate length and shape as well on a picture as we can in your mouth. So sometimes we get pictures or sometimes we have people who think they want really square teeth, and when they have them in their mouth, they don’t like them. Well, those temporaries allow us to work through those nuances and change the things that you want. Because in your mind, you know exactly what you want your smile to look like, and that’s what we do. We create that using the temporaries. Dr. Boulden: I think that’s a good point though. What you sometimes think is going to look good, like people bring me photos and this that, “I want this smile,” and then we kind of say, “Okay, we go that direction.” But then we actually transpose that onto them. Dr. Creasman: Right. Dr. Boulden: We find that sometimes it’s not the best fit. Dr. Creasman: Right. Dr. Boulden: And we have to go back and say, “Now we made a little too square, or too round, or too long, or too short, let’s tweak that now before we get to the final stage,” which is why we have a bunch of raving reviews and everyone loves our smiles that we create. It’s because we spend so much time in the preparation phase getting to that final stage. Dr. Creasman: Right. Invariably, consultation after consultation, I have people bring in photos from magazines, ripped out magazines of smiles that they thought were beautiful, and they are beautiful smiles on that model, but not necessarily on them. And so that what those temporaries allow us to do. They allow us to show the patient, “Hey, you may think this is a really great smile but it’s not just a really great smile for you.” Dr. Boulden: That’s good. Dr. Creasman: You’ll adapt to that, but the temporaries, they are just weaker, so don’t be concerned if you have a temporary come off. We can fix that, but that’s not representative of what you should expect with your final veneers.

Why Do We Spend So Much Time on Dental Temporaries?
We take our dental temporaries very seriously, and here’s why. The dental temporaries are really the most important factor to the success of what we get as a final product. The dental temporaries act as an ability to communicate what we want, and they also give us the ability to test drive that. Many people just place temporaries on, and you don’t even have a clue what they’re going to look like until you get the final product. And then it’s like, “We hope you like it.” So the reason that we spend so much time on these temporaries is because it predicts the success that you get with your final product.

Sleep Apnea

What Dentists Can Do For Your Sleep Apnea
I want to take a minute to talk about sleep apnea. Why would a dentist talk about sleep apnea? That’s probably what most people think because they don’t realize how common it is for a dentist to actually be the one that can help you with that. If you wake up feeling really tired or fatigued every morning, if your loved one who sleeps next to you reports that you choke or gasp or cough during the middle of the night, you may have sleep apnea. It’s actually really, really common. And a lot of people are suffering through it not knowing that they’re struggling through the night to breathe appropriately, and so they wake up just exhausted because your body is really struggling to survive while you’re asleep. And so it’s not just for the big middle-aged guy–which is what we kind of stereotypically think of as a CPAP patient, or a sleep apnea patient–but actually, very slim women even younger in their twenties and thirties, that’s one of the main risk groups. There’s a ton of women going through life struggling with sleep apnea that have no idea, and they really don’t think to ask or look into it because they don’t think of themselves as a likely demographic to suffer from it. So one of the things that we can do is we give you this little device. It’s an amazing thing. It’s called WatchPAT, and it won some awards a couple of years ago for being one of the best new medical technologies out there. And I’ve talked to some sleep physicians, and they say that it gives you pretty much all the same detailed information that you get from doing one of the sleep studies at an actual hospital or a sleep center, which is great because if you’ve ever looked into it, going to do a sleep center study can be a little awkward. You’re sleeping in this foreign place with a bunch of wires connected to you. There’s some guy sitting there kind of watching you sleep, checking monitors all the time. I personally don’t understand how that can possibly simulate a normal night for you because that sounds like a terrible evening to me. But what we can do is we send home this little device that you can wear in the comfort of your own home, and we do get a really, really accurate reading of how you’re breathing at night. It gives us a ton of information so that we can sit down together, talk about how well you breathe or you just snore, if you have mild, moderate, or severe sleep apnea. And there are folks that that need a CPAP, and a CPAP looks like a little fighter pilot’s mask that is a continuous positive airway pressure where it’s blasting air down your throat the whole night to make sure that you’re getting plenty of oxygen. That’s great and very helpful but as a general rule, people hate them. It’s very awkward to sleep with them. They have a mixed efficacy because in the middle of the night, people take them off because they’re uncomfortable. It’s hard to move around, and it’s very claustrophobic feeling for some folks. So what a dentist can do to help with that is, if you have the correct level of sleep apnea which is usually somewhere in the heavy snoring to about moderate range, we can make a device that helps posture your jaw forward. It’s like having two bite guards on at the same time, an upper bite guard and a lower bit guard, that helps posture your jaw forward that maintains that open airway so that you can sleep well and actually breathe throughout the night and stay healthy. Because sleep apnea puts an enormous tax on your body. It beats up your insides. It’s really wearing you out. You’re aging faster inside than you are outside, and it makes going through life tough because if you’re waking up exhausted every day, it’s a hard thing to get through the day as a productive member of society. So if you have any of these symptoms or if you’ve been told you have sleep apnea, if you have CPAP and you struggle with it, come chat with us because there’s likely something that we can offer that can be majorly life-changing. So I look forward to speaking with you, and let me know how I can help.

Sleep Study Instructions – WatchPat

If we’re sending you home to do a sleep study, the reason we would do that is to diagnose if you have sleep apnea. Or if we’ve already given you a sleep apnea device, we like to check on you along the way with one of these studies to see how you’re doing, see if we need to make any adjustments to get it working just right.

So we’ll send you home with this little box. Everything on this table comes in this box along with all the instructions that I’m about to show you. But it’s a little different, so I’m going to just walk you through how you put this on. You want to make sure you do this right before you go to bed, and make sure you’re totally ready. Just turn out the lights and go to bed. Because one you’re hooked up and you press the on button, you can’t turn it off, and you’re committed to the study for the night. So this is what it’s called the WatchPAT, and it’s called that because you put it on pretty much like a wrist watch. And I recommend doing this on your non-dominant hand so if you need to get up and do something in the middle of the night, you’re not tethered to the wrong hand. Also, be sure not to get this wet, so if you do need to get up, use the rest room or something in the middle of the night, please don’t wash this hand. So once it’s on, you take the finger sensor. This goes on your index finger. Inside this is a little squishy pillow, all right? So want it ease your way into it, but you want to make sure that your finger reaches all the way to the tip before you pull this tab off. What this does, you’re going to peel this tab up and straight back and pull all the way out, and that’s going to inflate the little pillow around your finger. This is really important, so don’t pull that tab before your finger is in it. Otherwise, you won’t be able to get the finger all the way in there. This little sensor has a picture of a finger on it. This will go on your ring finger, and you use that little picture to show you how to do it. So just peel off the sticky part on the back. And this goes, as you can see, the fingernail, right over your fingernail, and then you wrap it around to where it’s shining through the underside. So what this does, it shines a little infrared light through your fingernail. Once it’s on there, this long part wraps all the way around it to secure it just like this. So now that finger sensor is on and in place. The last part, I want you to make sure you’re wearing a t-shirt. You don’t have to, but if you’re a guy, you may end up donating some chest hair if you don’t because this is going to stick right about here in your upper chest. And then the last little circle part, it’ll actually go in this little dent right here at the bottom of your throat. And what I recommend doing is tilting your head up so that you don’t tether yourself. If you give yourself a stretch out as much as you can, stick it there, and you’ll be able to move your head around comfortably and had it be no big deal. These are going to measure your snoring, your position, blood pressure, pulse oxymetry. Tons of data is going to come from all these so that we can look at how you’re sleeping and figure out the best treatment for you or if we need to do anything else.

 

At Atlanta Dental Spa, we pride ourselves on being as conservative as possible, most of the time staying all within the enamel of the tooth. The enamel, believe it or not, does not have any triggers of sensitivity so we just don’t have complaints of saying, “Oh, my veneers are sensitive” or “My teeth are sensitive after veneers.” It usually just isn’t a problem. Again being conservative, it benefits you on a whole lot of levels: teeth not being sensitive, you’re preserving all your natural enamel, things like that. So really it pays to do your due diligence when looking to find someone who is gonna change your smile, and it’s an important thing because smiles are noticed just as much as your eyes. There’s actually a study done that said, “Which is the most important facial feature?” The study came back literally 50/50 that it’s either your eyes or your smile. We really don’t have the power to change our eyes so much, but we do have the power to change our smile, so it’s important to choose wisely.

Gummy Smile

Options For Fixing a Gummy Smile

Do you feel like you have a gummy smile? Let me give you two options that might be a quick solution for you that you can talk about during your consultation with us. Number one, it might be just a laser gum lift where we take a small little light laser and literally sculpt the tissue just a little bit higher. It’s an immediate result, and it takes about 15 minutes and it’s done just on a normal anesthesia. Another thing that I have been doing really recently is doing a little bit of Botox, Botox right on the elevator muscles of the smile, so a dot here and a dot here. What this does is it prevents the muscles from pulling so hard getting you that gummy smile. So when they don’t engage that much, the lip stays down a little bit lower and you don’t show as much gum.

Bridges

The Prettau Bridge and CT Scan Technology

One of the main new cutting edge treatment styles that we have to offer here is something called Prettau hybrid implant denture. Now, that’s a big mouthful. But what that means is teeth that are screwed into implants that you don’t have to take in and out, that are made out of a beautiful very strong material.

So historically, we used to use like a denture on a titanium bar, which is very easy to break. And now, it’s one solid piece of a metal that is just gorgeous and super strong. It doesn’t stain. It doesn’t chip. And it’s going to be, in my opinion, the future of denture dentistry. It truly is.

So I have this conversation a lot with people when they want to know if they’re eligible for that. And so what I’ve got here is a two-dimensional image, a panoramic x-ray of a patient who recently came in, and we’ve been talking about his options. He needs to lose his lower teeth. And his concern was that he had lost his back lower teeth a long time ago. And with that comes a lot of bone loss. And therefore, it makes it very difficult, risky, or you can’t place implants without traumatizing the nerve. Or it precludes them from having good treatment.

What people don’t realize is the bone in our chin is very, very dense. And it takes a very long time for that bone to go away. So most folks, if they have to lose all their teeth, actually have adequate bone to plan this kind of treatment. And so when we take a three-dimensional image with our CT scan, you can see here I’ve started the planning process a little bit.

And what I’ve got here is we’ve mapped out where his nerves are, so we make sure that we don’t involve those at all. Again, this is one of the best parts about this software is we can do a surgery in the computer before we ever do it in the mouth, so we know exactly what to look for and, boom, I just now removed the teeth. And all of sudden, I’ve got a jaw that I’m looking at. And we’ve got a beautiful amount of bone. We’ve got good height. I can check the density. That is like concrete. That’s exactly what we want. That’s terrific.

So this patient who thought he was about to be committed to dentures that are going to be uncomfortable and unpleasant and look not great, he thought he was about to be at that phase of his life. And I was able to show him this image and explain why we’re able to give him a wonderful treatment modality that’s really replacing his teeth that are going to be a heck of a lot better than what he’s been walking around with for years.

So this is a really valuable thing for us. And it’s a really valuable thing that we can offer to you as a patient. So if you’re in a denture currently, if you’re worried that you need dentures, if you have just a few teeth left, and you want to know what your options are, come in and talk to us because this is a wonderful new cutting edge thing that we’re really excited to offer for you.

Cutting Edge Technology

The Prettau Bridge and CT Scan Technology

People ask me a lot, “How safe is it to get a CT scan done?” And the answer is, historically, there was a lot of radiation involved. And medically, there is still a decent amount of radiation involved. But the reason I differentiate between medically and dental, a dental CT scan like we take here is about one thirty-seventh the radiation that a medical CT is giving you. So it’s much, much safer than it used to be. And it’s much, much safer than medical. To give you idea of how that translates, if you’d gone on a flight from Atlanta to LA, you’re receiving about the same amount of radiation that you get from a CT scan with us. And that CT scan gives us an enormous amount of information. We are able to truly do an enormous amount of virtual planning and protection for you, looking for important things, like where a nerve is, where pathology is, where sinuses are, things like that. And this is an example of doing an implant surgery here, that without a CT scan, there’s no way that I’m doing this, because you just need this quality of image to do this kind of surgery. So it’s worth it. It’s safe. And we use it routinely because it’s worth it and because it’s safe.

The Importance of CT Scans for Your Health

Today, I wanted to show you an example of how helpful a CT scan can be, because we’re going to do this routinely every time we’re going to do a dental implant or a wisdom tooth extraction or a root canal so that we have all the guesswork removed from the game plan. We always want to know what we’re doing before we do it, obviously.

So I’ve got this case pulled up because it’s a really nice variety showing how useful this machine is where I was doing this scan originally so that I could plan where implant placement was going to take place. And just to remind you, a CT scan is a three-dimensional image. So you can see here we’ve got the full mouth in three-dimensional image where I can move and rotate everything around. We can view it in lots of different formats. Here you can see it a traditional X-ray style. All these are virtual implants that I’ve placed. The colors denote different sizes.

I can do things like have it show me the bone density where I’m working. This shows very dense bones. That implant side is ready to go. Whereas, this one right back here, as I was doing this, that one was much softer. So we decided to give it a little bit more time to heal after the patient’s extractions and graft to allow that bone to mature so that we didn’t enter before it was ready.

Other things, you can map the nerve, which is obviously critical, so that we’re always avoiding any kind of trauma to a nerve or to a sinus, things of that nature. And one thing that’s really helpful is being able to evaluate older dentistry. What I mean by that, as I scroll along through here, this is an example of what a root canal looks like. So you can see the bright white line in the middle of the tooth. And that’s showing us what fills the tooth once the root canal has been completed. And we look at the tip of the root here, and we look at the quality of the bone around it to evaluate how well this root canal is doing and holding up. And what we did when we first evaluated this patient is we were planning for implants, like I said. But we stumbled across some older dentistry that we wanted to make sure she got evaluated before we proceeded with treatment.
Such as this root canal, there we go. We can see that the tip of this root is poked all the way through this plate of bone. And we got a little darkness at the tip here and there, which can be a sign of recurring infection, things like that. So some of these things really didn’t show up on the other X-rays of this patient that we had, and the three dimensions really allows us to get into the nitty-gritty of it. And so we can figure out all these things that are going on.

Another thing is as we’re scrolling along through here, this is me going up and down. A CT has three-dimensional image that chops you into slices, like a deck of cards, from top to bottom, front to back, side to side. So we have the ability to move up and down and all throughout your skull to evaluate things. And as we’re doing this, I noticed this whole side of her nose is pretty inflamed and pretty closed up. So we asked, “How is your breathing doing?” And she had said that she has been having trouble breathing well out of her right side. And so we got to say, “Look, we can see an enormous amount of inflammation.” We gave her a referral to an ENT. So things like that that, they’re total just random finds. But they’re really helpful.

We stumble across pathology like this frequently where we’re looking at one thing and we find something that’s undiagnosed that the patient is walking around with. And that’s one of the major benefits about not only how safe this makes future treatment, but it also is a safety factor in that it’s very diagnostic for all of the stuff that’s hiding quietly behind the scenes that may be important. And so if we can come across things like pathology, I can email this to a specialist where they can do a full radiology report in a matter of a handful of days. We can have CAD/CAM-style surgical guides fabricated from this to allow me to place the implant in precisely the exact spot and position that I want to remove all chance of going anywhere but that, which is really, really important and makes for a very safe surgery. It also makes very complex surgeries much, much more straightforward.

So it’s a really powerful, wonderful software. And we use it on a daily basis. Like I said, if you’re in Buckhead walking around, there’s a good chance you’re going to see me sitting here because we do this for everybody.

What is a CT Scan?

I have to talk about bone grafts very frequently on a day-to-day basis here. And the reason for that is because we want to make sure that you always have all the teeth that you should have. And when you lose a tooth, that bone that used to hold that tooth starts to dissolve away. It exists only to hold that tooth. So when the tooth’s gone, it starts to atrophy, and we start having issues with putting an implant there to give you your tooth back.

So that’s why we talk about bone grafts because if you don’t have enough bone, we can generally rebuild enough to allow the implant to be placed where it should be to give you the tooth that you need. But there’s also a lot of different types of bone grafts, and people always want to know, what am I talking about when I say bone graft. And there’s a pretty big spectrum there.

The easiest, most straightforward, least expensive, least painful kind of thing in the world is when the tooth comes out, that very same minute, we put in a bone graft. And that means we’re just filling the socket that used to hold the tooth with bone. And the analogy that I give my patients on a pretty daily basis is, you know, if I ask you to build a wall and just gave you nothing, you’d have to wander around and find rocks and assemble your wall, right? Or if I gave you a pallet of bricks and said, “Build a wall” you can assemble a really good one, really quickly.

That’s kind of what I’m doing for your body. I’m giving the bone right there all of the materials it’s needing to build you good quality bone in an adequate amount to give us a really good predictable implant site down the road. So that’s what we call a site preservation, meaning we’re preserving that bone that would normally shrink away so that we can put an implant in pretty shortly thereafter. That’s really, really common and highly recommended.

People are always like, well, am I a candidate for that? Pretty much everybody’s a candidate for that. And then they always want to know, well, what is it, you know? And there’s lot of different kinds of bone grafts.

Bone grafts can come from you. It can come from a cadaver which is also pretty common. That always freaks people out a little bit. Don’t sweat it. What it is, is it’s very sterile bone chips that technically, yes, they do come from a cadaver, but when we put it in there, I’m giving you that pallet full of bricks. Your body will break that bone down and re-assemble it as part of you. So if we came back and took a biopsy of that bone six months down the road, it’s you. It’s 100% you. You’re not walking around with Joe over here. People are all so weirded out by that, but it will be absolutely your bone.

Does it have to be cadaver? No, it doesn’t. There’s also other types. We can do what’s called a xenograft which is just a fancy way of saying from a different species of… Bovine is really common, pig bone, whatever. If that freaks you out too, there’s synthetic grafts. That’s where we use, pretty much, the mineral components that bone’s assembled from. We put that right there, and your body can build it too.

So, you know, whatever your hang-up is with whatever the type of bone graft is, let’s talk about it because we do have a lot of options. And we can make that a non-weird event for you because it’s a really important thing so that you get a good predictable outcome.

There’s also more extensive kind of bone grafting that it’s hard to explain it here when we’re not in person looking at your scenario, but know that if you’re missing width, if you’re missing height, if you have a large sinus where an upper molar used to be, we can fix pretty much all of those things.

So come in. Let’s talk about it and just know that about 60% of implants requires some level of bone grafting. So it’s really common, it’s not a weird or hard thing. We do it routinely, and we can talk about what fits your scenario best.

Can CT Scans Save Lives?

So I want to take a second to show how important it is to have a CT when you’re really curious about an unknown of any kind. And what I mean by that is this is a great example. This patient came to see us for a variety of teeth that she was having trouble with that are pretty evident. If you glance at this, even if you’re not trained dentally, you can probably observe that there are some not great things going on here in her mouth.

So she came to have us evaluate this and figure out what’s going on. And when we took this X-ray, which is a panoramic X-ray, it’s a two-dimensional thing that shows your whole face, obviously, and we saw this little cloudiness in her cheek up here. Some folks may just think, “Okay, that’s just a little artifact or something. Or she moved a little bit. We had a little blur. Maybe she had some fluid in her sinus,” something like that. But she had a little puffiness in her cheek. So we wanted to take a CT scan to make sure we weren’t missing something.

And what we did is we took a CT scan. And I’m really glad we did because we had to rush this lady over to an oral surgeon’s office for some really invasive surgery. Because as you can see on this CT scan, this is what her left side looked like. We got this big plate of bone. And on her right side, there is no bone. It’s a giant crater. And what we found is that she had an enormous cyst that had basically…It was almost like she had two sinuses built on top of each other that she had no idea and was just walking around through life with this enormous problem in her head. We luckily diagnosed that just from a CT scan. And so she was rushed to get some pretty emergent care. And she’s doing great. We had her in just a couple of weeks ago as a follow-up, and she’s doing really well.

So this is just one of the important things of looking out for a patient’s well-being and having the extra diagnostic tools to make sure that we’re not missing things. So when we’re here and if we recommend a CT scan, I promise it’s for good reason, because we’re looking out for you to make sure that we’re not missing stuff like this.

How CT Scans Help Us Help You

If you’re ever walking around our Buckhead office, this is a pretty common sight, me sitting here at our CT machine planning out a case, figuring out how to protect our patients from any unnecessary, risky outcomes. We always enter into every procedure knowing our final game plan before we even start. And that’s really critical whenever you’re doing any aspect of dentistry, whether it’s creating a blueprint in porcelain for the veneers that are coming or doing a virtual surgery on a computer before we actually do the procedure in the mouth. So that way, we know everything that’s going to happen before it happens or at least as much as is absolutely possible.

So it’s a really powerful software and a wonderful machine. It allows us to take three-dimensional images in three different sizes, where we can focus on a tooth or two. We can look at a quadrant or a full arch. Or we can look at your whole mouth at one time.

And there’s lots of different reasons that we do this. We look at root canals to make sure that they’re healthy and look for variable anatomy that makes it very difficult to do that procedure well if you don’t have this kind of imaging.
For every implant procedure, we’re going to do this every single time so we know exactly what size implant, position, angulation. It allows me to do a little virtual bone biopsy, so I know the density of the bone, so I know what protocols to follow.

We can find pathology. We can look for infection. We can evaluate the nerve in relation to your wisdom tooth so that if your tooth is in a position and a place that makes it risky, we know how to avoid any kind of trauma or damage to the nerve.

So it’s a very helpful thing for us on every level. It’s a safe thing for you. Also, speaking of safety, a lot of people are always concerned about the amount of radiation from a CT scan, because they think of a medical CT scan. Our CT scan is about one thirty-seventh of the radiation of a medical CT scan. We don’t need the level of resolution that they do in a medical CT scan for what we’re doing. We have very high-definition stuff here that gives us exactly what we need at such a low dose that that part is pretty negligible.

If you consider dental X-rays from back 10, 15 years ago, just a handful of irregular checkups with X-rays is about the same as what our current three-dimensional imaging is. So don’t let the radiation part be a holdup for you, because it’s so critical for good, proper planning to keep you safe and make our treatment predictable.

Wisdom Tooth Removal

Trauma-Free Widsom Tooth Removal with CT Scan

If you come to see us to talk about wisdom tooth removal, we’re going to probably do a lot of diagnostic investigation before we actually proceed with the treatment to make sure that it’s always very safe and predictable, because there’s a major nerve that runs through our jaw on each side. And often, the lower wisdom teeth are positioned very close to that nerve. And if they’re close to that nerve or touching that nerve, when the tooth is removed, it can traumatize that nerve. That’s what nobody wants. That can lead to nerve damage that can be temporary or permanent. I don’t want to scare you away from it. This is exactly why we do these things so that we can avoid those things.

And so what I mean by that is when we take a panoramic or traditional-style X-ray, that’s a two-dimensional X-ray, okay? So that means your nerve and your tooth may overlap on that X-ray. And what looks to be overlapping, in reality, that’s the two-dimensional version of a three-dimensional thing, meaning your jaw. It may not be accurate. So the nerve, which looks like it’s right on top of it, may actually be really far one way, really far the other, or it may truly be involved. So when we have that concern that there is overlap with the nerve, we take a CT scan to get a three-dimensional image of where that tooth is in relation to the nerve.

On this one, you can see the red line here. I was able to map out the position of the nerve as we go through slice by slice here. And we can evaluate where it is in proximity to different parts of the tooth and decide, is it safe to take out this tooth? If we do take out this tooth, am I going to change my approach on how to do it so that we avoid nerve trauma? And as you can see from this one, this patient, it truly does come very, very close to the roots of the tooth where we have to keep that in mind so that we don’t cause any kind of nerve damage, which, whether it’s here or elsewhere, if your tooth looks like it’s on the nerve, I encourage you to make sure you find an office that uses CT diagnostics to make sure that they’re doing everything they can to protect you ahead of time.

What is PRF and How Does it Jump-Start My Healing?

One of the things I want to talk about today is what’s called PRF, that’s platelet-rich fibrin. That word’s not very important, what’s important is what it is. It’s a thing that I learned about in some extensive grafting training during my residency where basically you have, throughout your body, all the things required to heal. We all know that. When you get a cut and your body can fix it, right? You break a bone; it will heal if you allow it to.

That’s because we got all these little important molecules floating around in us in a very dilute form. When you have an injury, those things have to trickle to the part to help start fixing it.

What PRF is it’s a concentration of that. So if we’re doing any kind of oral surgery, like I said, I learned this word, “extensive grafting,” but because it works so well, I started doing it for everything. That includes wisdom teeth, a simple single tooth extraction, implants, sinus lifts, other types of bone grafting. We use it on everything because there’s no downside to it, honestly.

What it is, is when you’re sleeping–because we do IV sedation for most everything we do here as far as oral surgery goes–we draw just a couple of vials of blood, just like if you’re giving a sample to the physician’s office. While we’re working, I’m centrifuging that blood. It separates the blood out into two parts, the part that has nothing to do with healing, and it concentrates the part has everything to do with healing. That’s our PRF.

It’s full of your growth factors, your hormones, your platelets, fibrin–the PRF part fibrin–that’s the part that needs our blood clot. So what we’ll have it a pure clot in this test tube, concentrated with all of those really important, very helpful molecules that we can take in a preformed clot, place it right wherever that oral surgery took place.

The tooth comes out, and we put that clot right in there and it jump starts the healing process. That means it minimizes pain, minimizes swelling, speeds up how quickly whatever it is closes up, it’s got really important proteins that are called bone morphogenetic proteins. And it’s not important that you know what that is, just that they’re there and that it’s really really helpful.

It speeds up every part of your healing process. So when I check on you about two weeks after whatever procedure we do, it’s uncommon that it looks like it’s been four weeks. It’s amazing stuff. It’s kind of like our body’s version of miracle growth. There’s no way that you can be allergic to it because it’s your blood, and it’s just the refined, best version of you, so we take out the stuff that is diluting what’s normally floating around. We concentrate all the good stuff, we put it right to where we want something to heal fast and it does exactly that. It’s amazing stuff.

When you’re here, we’ll talk about it more, but just know that we go out of our way to take that extra step no matter what level of oral surgery you’re going under to make it the easiest thing possible.

What is Dry Socket and How Can I Prevent It?

What is dry socket? I get that question a lot. Dry socket is no fun, I’ll tell you that. It’s also pretty common when it comes to extractions, especially lower wisdom teeth.

And everybody’s heard about it. Everybody knows a guy that had a bad dry socket experience. It’s what scares a lot of people away from having their wisdom teeth taken out or what makes them nervous when they need some sort of extraction done.

Well, dry socket is when the tooth comes out, just like if I cut my arm, and I’m going to have a scab form on my arm. A scab forms where the tooth came from too. But we don’t call it a scab in the mouth. We call it a blood clot.

It fills up where the tooth used to be. And it firms up over the course of a day or two. It sits there, and it starts the normal healing process.

What a dry socket is is once that clot’s there, it gets dislodged somehow. The most common reason is smoking. Somebody goes home, and they smoke a cigarette, not only is it the toxins in the actual smoke, but it’s the suction of pulling on the cigarette. So the same thing can happen if you use a straw. For a few days right after an extraction, we really encourage you do not to use straws. If you go get a milk shake or smoothie or something afterwards, that’s great, just eat it with a spoon. That heavy suction when you’re pulling on a straw can dislodge that blood clot.

Also if it’s in the first 24 hours or so after your surgery, you don’t want to do any heavy rinses, heavy spitting, heavy swishing. If you feel gross or something after you’ve had your wisdom teeth out, that’s fine and okay and normal. Just get a wet wash cloth and wipe out your mouth instead of rinsing and spitting for that first day or so.

Let that clot firm up. Just like if you sat there and picked that scab on your arm over and over, it’s never going to heal right. When that clot dislodges, if it does, we’ve got exposed bone in there. And that hurts like crazy. It’s no fun. It’s really unpleasant. And it lasts for about two weeks.

And there’s not a lot of treatment to be done for it. Yes, you come in, and we can put a medicine down in there. And we can give you painkillers and things like that. We can numb you up. But who wants to come back to have us poke around in the thing that really hurts? No one wants to get another injection. We really prefer not to give you a bunch of painkillers on top of the ones you’re already taking.

We can avoid these things if you follow our instructions. But there’s also a couple really helpful things that we do here. We try to go above and beyond on your average extraction here. I try my best to give everyone a very easy extraction experience, and a dry socket is not an easy experience.

So one of the things we do is we place what’s called platelet-rich fibrin. Make sure you watch my PRF video where I go into more detail about that. But it’s a preformed blood clot formed from your own blood that’s very easy. And it basically jumpstarts the whole healing process. And it really, really lowers your chance of having a dry socket. So it’s very, very helpful. And we find that folks have a really good experience when we do that. And we do that routinely here.

The other thing that we can do is if it’s a tooth that we’re planning on putting back, so it’s not a wisdom tooth, but it’s, say, a molar over here that we want to put back, a lot of times, what we’ll do is we’ll do a socket or site preservation bone graph, meaning the tooth comes out. We fill that right away with bone to give us a really good chance that an implant shortly thereafter. And what that does is that has now filled up that socket, so you can’t get a dry socket. We’ve already covered it and protected it so we can keep you from having that experience.

So that’s a little background on dry socket. We have a really good track record with all those little tips and tricks that I just gave you of not really experiencing many of those around here. So don’t sweat it. Come talk to me. And I can put you at ease because that’s something that we’re pretty much getting rid of.

Dental Implants

Who Needs Bone Grafts and Why?

I have to talk about bone grafts very frequently on a day-to-day basis here. And the reason for that is because we want to make sure that you always have all the teeth that you should have. And when you lose a tooth, that bone that used to hold that tooth starts to dissolve away. It exists only to hold that tooth. So when the tooth’s gone, it starts to atrophy, and we start having issues with putting an implant there to give you your tooth back.

So that’s why we talk about bone grafts because if you don’t have enough bone, we can generally rebuild enough to allow the implant to be placed where it should be to give you the tooth that you need. But there’s also a lot of different types of bone grafts, and people always want to know, what am I talking about when I say bone graft. And there’s a pretty big spectrum there.

The easiest, most straightforward, least expensive, least painful kind of thing in the world is when the tooth comes out, that very same minute, we put in a bone graft. And that means we’re just filling the socket that used to hold the tooth with bone. And the analogy that I give my patients on a pretty daily basis is, you know, if I ask you to build a wall and just gave you nothing, you’d have to wander around and find rocks and assemble your wall, right? Or if I gave you a pallet of bricks and said, “Build a wall” you can assemble a really good one, really quickly.

That’s kind of what I’m doing for your body. I’m giving the bone right there all of the materials it’s needing to build you good quality bone in an adequate amount to give us a really good predictable implant site down the road. So that’s what we call a site preservation, meaning we’re preserving that bone that would normally shrink away so that we can put an implant in pretty shortly thereafter. That’s really, really common and highly recommended.

People are always like, well, am I a candidate for that? Pretty much everybody’s a candidate for that. And then they always want to know, well, what is it, you know? And there’s lot of different kinds of bone grafts.

Bone grafts can come from you. It can come from a cadaver which is also pretty common. That always freaks people out a little bit. Don’t sweat it. What it is, is it’s very sterile bone chips that technically, yes, they do come from a cadaver, but when we put it in there, I’m giving you that pallet full of bricks. Your body will break that bone down and re-assemble it as part of you. So if we came back and took a biopsy of that bone six months down the road, it’s you. It’s 100% you. You’re not walking around with Joe over here. People are all so weirded out by that, but it will be absolutely your bone.

Does it have to be cadaver? No, it doesn’t. There’s also other types. We can do what’s called a xenograft which is just a fancy way of saying from a different species of… Bovine is really common, pig bone, whatever. If that freaks you out too, there’s synthetic grafts. That’s where we use, pretty much, the mineral components that bone’s assembled from. We put that right there, and your body can build it too.

So, you know, whatever your hang-up is with whatever the type of bone graft is, let’s talk about it because we do have a lot of options. And we can make that a non-weird event for you because it’s a really important thing so that you get a good predictable outcome.

There’s also more extensive kind of bone grafting that it’s hard to explain it here when we’re not in person looking at your scenario, but know that if you’re missing width, if you’re missing height, if you have a large sinus where an upper molar used to be, we can fix pretty much all of those things.

So come in. Let’s talk about it and just know that about 60% of implants requires some level of bone grafting. So it’s really common, it’s not a weird or hard thing. We do it routinely, and we can talk about what fits your scenario best.

What is PRF and How Does it Jump-Start My Healing?

One of the things I want to talk about today is what’s called PRF, that’s platelet-rich fibrin. That word’s not very important, what’s important is what it is. It’s a thing that I learned about in some extensive grafting training during my residency where basically you have, throughout your body, all the things required to heal. We all know that. When you get a cut and your body can fix it, right? You break a bone; it will heal if you allow it to.

That’s because we got all these little important molecules floating around in us in a very dilute form. When you have an injury, those things have to trickle to the part to help start fixing it.

What PRF is it’s a concentration of that. So if we’re doing any kind of oral surgery, like I said, I learned this word, “extensive grafting,” but because it works so well, I started doing it for everything. That includes wisdom teeth, a simple single tooth extraction, implants, sinus lifts, other types of bone grafting. We use it on everything because there’s no downside to it, honestly.

What it is, is when you’re sleeping–because we do IV sedation for most everything we do here as far as oral surgery goes–we draw just a couple of vials of blood, just like if you’re giving a sample to the physician’s office. While we’re working, I’m centrifuging that blood. It separates the blood out into two parts, the part that has nothing to do with healing, and it concentrates the part has everything to do with healing. That’s our PRF.

It’s full of your growth factors, your hormones, your platelets, fibrin–the PRF part fibrin–that’s the part that needs our blood clot. So what we’ll have it a pure clot in this test tube, concentrated with all of those really important, very helpful molecules that we can take in a preformed clot, place it right wherever that oral surgery took place.

The tooth comes out, and we put that clot right in there and it jump starts the healing process. That means it minimizes pain, minimizes swelling, speeds up how quickly whatever it is closes up, it’s got really important proteins that are called bone morphogenetic proteins. And it’s not important that you know what that is, just that they’re there and that it’s really really helpful.

It speeds up every part of your healing process. So when I check on you about two weeks after whatever procedure we do, it’s uncommon that it looks like it’s been four weeks. It’s amazing stuff. It’s kind of like our body’s version of miracle growth. There’s no way that you can be allergic to it because it’s your blood, and it’s just the refined, best version of you, so we take out the stuff that is diluting what’s normally floating around. We concentrate all the good stuff, we put it right to where we want something to heal fast and it does exactly that. It’s amazing stuff.

When you’re here, we’ll talk about it more, but just know that we go out of our way to take that extra step no matter what level of oral surgery you’re going under to make it the easiest thing possible.

Dentures

Dentures Aren't a Life Sentence Any More!

This video is for all of my denture patients or patients who have been told that they need a denture. Something that people look at or consider as just kind of a life sentence is when you get a set of dentures. You know, people think they’re going to go through life struggling or not being to chew or being afraid to smile or you know, “Is this thing going to move around constantly when I’m talking?” And the answer to a lot of those things, historically, has been yes. Dentures can be a very, very difficult thing to live with. But the good news is we’ve improved a lot. We’ve got a lot of things that we can offer in a big, big variety of ways to improve everything that you have going on with your current denture.

To put it in perspective, when you have a mouthful of healthy teeth and you’re able to chew at a 100%, that’s terrific. But if we take out all of those teeth and make you best set of dentures in the world, the hardest you can chew is about 25% of what you could when you had natural teeth. That’s because you’re biting with plastic dentures, squishing on gums that are squishing on bone. Everything there is kind of soft and squishy and has some give to it, and nothing is really attached to your jaw like your teeth used to be. So you can’t apply that much force, which makes it pretty unpleasant or hard to deal with.

You know, on the roof of your mouth is a nice big hard plate of bone which allows for good suction with an upper denture. We can do those predictably and make them look good and feel pretty comfortable, that’s great. But the lower dentures are an entirely different story. We have a lot of muscle attachments down here, the tongue is always moving around trying to knock it out of place. There is no big flat plate of bone like there is in the roof of your mouth to get that good suction. And a lower denture can be a real struggle. And even if you’re an excellent dentist, and you have a patient that has an excellent jaw to work with, if you will, it still can very, very challenging, it can be very frustrating for the patient and for the dentist.

Now most patients don’t have a great jaw to work with on their lower jaw, because as you lose teeth, the bone that used to hold those teeth goes away. It shrinks down, and now, we’re working with and much closer to a flat surface in there which makes it extra hard.

So how do we fix this? How do we improve it? The way that we like to improve it is what’s called an overdenture. An overdenture is a denture that attaches to dental implants in one form or another. One of our preferred methods is what’s called a locator overdenture. That part is not important really, but know that it’s a snap-in denture. So what we do is we place a couple of implants at a minimum, at least two, and ideally, more than that.

But the reason I brought up the 100% of chewing with all of your teeth, the 25% of chewing with a brand new set of dentures is because when you add in two implants right here where your lower canines used to be, you immediately jump to about 60% of chewing ability. That’s huge when it comes to life experience and the quality of life when you’re trying to chew, when you’re worried about your denture moving while you’re speaking to someone. With every additional implant, that percentage goes up and up and up to where we can get you back to darn near 100% chewing depending on how many implants we put in.

So what it is, is we retrofit the denture, meaning if you have an existing denture that you like, a lot of times we can use that and just upgrade it. Sometimes we’ll make a new one from scratch, but we put dental implants in your jaw and we attach a locator, as I mentioned, or a snap. It looks like a little brass snap that’s sticking up through the gums. And inside the denture, there’s the corresponding snaps. You put it in and it clicks into place. And once that happens, it’s very firm. And when you bite down, now instead of acrylic squishing on gums squishing bone, it’s acrylic that’s attached to an implant that’s in your bone. And so that means forces are being transmitted into your jaw as you’re chewing. You get a lot more perception of how you’re chewing, you can bite much, much harder.

And what’s great about it is on top of all these things I’ve already mentioned, that force that’s being transmitted down into your jaw actually stimulates the bone to maintain. As I mentioned, when you take out teeth, you start losing that bone. That process will continue throughout your life. And so if you lose all your teeth pretty early in life, you’re going to end up really struggling as it goes along, because you’ll get down to just a tiny little bit of bone and that’s a very difficult way to go through life.

So with these implants…

Sedation Dentistry

Managing Dental Anxiety with IV Sedation

I’m a dentist. What that means for me on a daily basis is that somebody like yourself tells me that you don’t like coming to see me. I get that every single day and I get it. I understand that it can be a stressful thing, it can be a scary thing, it can be an uncomfortable thing to have dentistry done. We understand that. The good news is we can also make it a very, very easy experience for you here. And the reason I say is because we offer I.V. sedation here.

That’s something where you may have heard of twilight sleep or conscious sedation. The reason it’s called those, conscious sedation or twilight sleep, is because it’s not general anesthesia. General anesthesia is very, very deep. It’s much more serious and much more risky. There are absolutely good indications for that. You need a surgery in an OR, that’s what general anesthesia is for, absolutely.

I.V. sedation, it’s very safe because we can reverse everything we give you, so we can wake you up like that if we want to. It’s called a conscious sedation which is terrible term for it because you’re snoozing right through the procedure, but the conscious part means that your body’s safety faculties are still there.

So you can talk to us and say, “Hey, I’m uncomfortable,” or, “I’m waking up,” or whatever. You can’t have that “I’m trapped in my body and I can’t tell the surgeon that I’m awake” kind of thing with I.V. sedation. So that’s a common question I get, so don’t worry about that.

So you don’t ever remember those conversations. We can ask you to scoot up in the chair or turn to the right or whatever, and you just are kind of cruising right through it and not having any idea that took place.

So the reason that we like to offer that for not just surgery, because we do it for anything if you want to, really, is because we know how much people don’t like being in our chair. And that’s okay. And if I’m doing oral surgery, it’s a great way to have surgery done because you can forget the whole process, right? But it also allows me to give you things in the I.V. that make your first few days much more comfortable–things that minimize swelling and discomfort for about 48 hours, things that keep you comfortable for longer that first day.

Also, the reason it was brought into dentistry is actually because it makes it even safer for certain people in the population–meaning, folks who have a cardiac history. A lot of times dentistry can be stressful, and people’s blood pressure gets elevated when they come to see us. That is not what we want to do. We want you to have a very low-key, enjoyable experience.

So the safety party for sedation is for a cadio-protective approach, if you will, where if you’ve had a history of a heart attack or a stroke, a very high blood pressure, that sedation allows your blood pressure to maintain at a very safe level, and even if it did elevate, then I can give you something in the I.V. that immediately makes it drop down to its safe level again.

So it’s there for your protection, your enjoyment, your comfort. It makes it easy for us to work, and it makes a very long day sometimes seem like it’s a very, very short day because it kind of deletes your perception of time. So it’s a really pleasant way to have dentistry done no matter what the procedure is.

And we can do it, like I said, as a tag-team approach where if you’re getting that cosmetic procedure done, say like veneers, where I’m more like your anesthesiologist for day, keeping you sleeping right through it. Or if it’s a natural surgery procedure, we’ve got you covered there, too.

So come talk to us about it. It is something that’s pretty unique. About 4% of dentists in Georgia have a license for sedation. So we’re a little hard to find sometimes. But we offer it here, and I’d love to talk more about it with you in person.

Cavities

Possibly Reversing Cavities. Less Drilling is a Good Thing!

No one wants to come to the dentist and have a cavity drilled out. If there is a way for us to prevent that and keep you healthy, that’s what we all want. We now understand the mechanisms of how cavities work, and we understand that it takes a perfect storm of several factors coming together to create a cavity. By controlling those factors–controlling the pH, the minerals available, the food source, things like that–we can actually prevent cavities from progressing to where you need to have us drill it out, which is a win for everybody.

So here’s what we do. We prescribe a series of rinses, gums, and products that allow us to reverse that damage and save your natural healthy tooth structure. The only way for us to know if you’re a candidate is for you to come in and let us take a look and see if we are in a stage that we can reverse these cavities without us having to drill on your tooth.