Smile Gallery

Our patient was looking to rejuvenate his smile after many years of fillings, wear, and chipping of his front teeth. Our challenge was to match new crowns and veneers to an existing bridge. 

We started by making a 3D printed digital prototype to simulate the final desired outcome. Then based on the 3D digital prototype, we reshaped and rebuilt the lower front teeth with direct composite veneers This created the space we needed to make crowns and veneers on the upper front teeth. The top and bottom teeth need to work together in harmony and frequently cosmetic treatment on the top ...

We often get the question, why do my fillings need replacement?

The answer is not always simple.

This patient had multiple fillings failing in different ways:

Our patient had a small gap between her front teeth. She had orthodontic treatment in the past, but didn't wear her retainer and the teeth moved. We discussed the options of direct tooth colored filling material to close the space versus Clear Correct (clear aligners) orthodontics to close the space. She ultimately opted for Clear Correct orthodontics to close the space because it didn't require any shaving down of the teeth. A bonded (glued on) retainer was placed on the back side of the teeth to hold them in the desired position at the end of treatment. The outcome was ...

Our patient initially came in with tooth wear and acid erosion on her front two teeth. We discussed the treatment options and decided to use a direct composite veneer to improve the length of the teeth while also repairing the damage from tooth wear and acid erosion. 

Many years ago porcelain fused to metal (PFM) crowns were the only cosmetic crown option available. PFM can be a very successful crown option, but one of the problems with them is the appearance of a dark line where the crown meets the tooth. The dark line can be due to metal showing, from a lack of translucency (light can’t pass through the metal), or from new decay along the edge of the crown.

 

Our patient had porcelain to metal crowns on his two front teeth and didn’t like the dark appearance where the crowns were meeting his teeth. He also ...

This new patient was getting ready for her senior pictures and came to us with a chipped front tooth. The fracture included the hard outside enamel and the softer dentin on the inside of the tooth, but thankfully the nerve was not exposed and there was no pain. 

We scanned her teeth with our 3Shape Trios scanner to create a digital model of her mouth. We then sent the scans to our lab partners at Keating Dental Lab. They were able to digitally repair the broken tooth by making a mirror image copy of the unbroken adjacent tooth. Keating ...

Outside of trauma, gaps in the smile can occur for a variety of reasons. Sometimes it's because the jaw grew too big and now your teeth aren't able to fill all of the gaps. Other times it's because your teeth developed too small, so there are large gaps. It could even be a combination of the two. 

To correct the gaps: 

• Orthodontics can be used to change the position of the teeth and the shape of the jaw
• Composite bonding or ceramic veneers can change the shape of the teeth
• A combination of both can be used

Our patient came in wanting to eliminate the ...

Tooth colored fillings on back teeth are one of the most common procedures completed by general dentists, yet they can be very technique sensitive. Some of the challenges can include:

• Poorly contoured tooth colored fillings can trap food and plaque in between the teeth leading to new cavities or gum problems
• Inadequate isolation can cause contamination of the tooth by saliva or bacteria which can interfere with the bond between the filling material and the tooth
• Improperly followed bonding instructions may prevent adequate sealing of the filling material to the tooth

Our patient presented with a food trap between their teeth causing new decay ...

3D printing is relatively new in dentistry, but it has opened doors for patients that may not have otherwise been able to afford care. We now have the ability to 3D print dentures, nightguards, models, implant surgical guides, and in certain situations crowns. 

This patient came to us because she was unhappy with the existing composite bonding and was looking for a solution that would not break the bank. We went through the process of making a digital smile design that allowed her to visualize the potential outcome before we started working on the teeth.

We used the digital smile design as ...

A long term patient of our practice broke the crown off an endodontically treated tooth and unfortunately the tooth was non-restorable. 

We were able to place a dental implant at the same time we removed the tooth (immediate dental implant). After four months of healing we made a temporary crown to create an ideal shape to the gums around the implant. Shaping the gum tissue helps to minimize getting food trapped around the implant and guides the laboratory on how to shape the final crown. 

The final restoration was custom ceramic crown fitted to a custom gold-hue titanium abutment. The final photos ...

We offer three different levels of professional tooth whitening in our practice including: 

• In-office whitening with Opalescence Boost (40% strength)
• Custom take-home whitening trays with Opalescence (range of strength from 10-35%)
• Pre-loaded Opalescence Go whitening trays (10-15% strengths)

Most whitening products will improve the color of the teeth. The stronger the concentration of the whitening product, the faster the results, but also the higher the risk of sensitivity. 

For this patient we used a 20% strength Opalescence gel in a custom take-home whitening tray. This offered a good balance between the risk of sensitivity and the desired color improvement, while also protecting the gums from ...

Many patients have large silver (amalgam) fillings and they may last for many years or decades. Several things can happen to silver fillings over time though, including: 

• Staining or discoloration of the healthy surrounding tooth structure
• Corrosion leading to leaking margins
• Decay along the leaking margins or under the silver filling
• Cracks in the healthy surrounding tooth structure
• Chipping, cracks, or even loss of the silver filling itself

This patient had a large silver filling that was more than half of the chewing surface of the tooth and had a leaking margin with decay underneath the filling. After discussing the options we opted for a tooth ...

We are always excited to help patients restore the confidence in their smile. This patient had several large cavities that were causing discoloration of the teeth, were sensitive to cold and sweets, and were making it difficult to keep the teeth clean. 

In one visit, we were able to remove all the decay on five upper front teeth and one lower front tooth. We then used a tooth colored filling material to replace the missing tooth structure, close the space between the front teeth, and restore the smile.

If you would like tooth colored fillings to fix spacing between teeth ...

Sometimes accidents happen :( Our patient was hit in the mouth while at work and fractured two natural teeth and a crown. We completed a root canal on tooth #8 because the nerve was exposed. Then we prepared tooth #8 and 9 for crowns. The chip on the edge of tooth #10 was small and easily repaired with composite filling material. The final crowns were cemented and adjusted to fit perfectly with the opposing teeth. We were thrilled to be able to restore the teeth to a beautiful, natural smile!

Contact us today to schedule your appointment!

No need to feel embarrassed about a chipped tooth, we can help fix that. A previous injury to our patient's tooth was repaired with a direct composite tooth colored veneer. Unfortunately, over time the veneer chipped and a cavity developed.

We removed the decay and the previous veneers. Then sculpted two new direct composite veneers to blend in naturally with our patient's smile. 

Contact us today to schedule your appointment!

Sometimes the best replacement is with the natural tooth. Our patient accidentally broke his front two teeth (#8 and #9). Luckily, he kept the broken fragments and brought them to his emergency dental appointment. We were able to complete a root canal on tooth #8 because the nerve was exposed. Tooth #9 didn’t have a nerve exposure, so it did not need a root canal at this time. We carefully cleaned the teeth and the broken fragments. Then we reattached the broken portions with tooth colored filling material. We adjusted the teeth to minimize pressure on them when chewing, then ...

It can be scary to lose a front tooth! Thankfully dental implants can offer an excellent solution to replace a single tooth without harming the adjacent teeth. 

For our patient, a dental implant replaced the root of the missing tooth and the bone of the jaw healed around it. Sometimes we are able to make an immediate temporary crown or a temporary replacement option, but our patient opted to go without any replacement while the implant healed. After the implant healed we were able to create a custom crown to blend in naturally with the other teeth.  

The implantwas placed into the ...

This patient initially came in looking for a more cosmetic option to replace their silver (amalgam) fillings. After a comprehensive exam and evaluation we discovered decay under several of the silver fillings, but not all. Silver (amalgam) fillings can be an excellent treatment option and last a very long time, but replacing them simply because they are not tooth colored is not something we typically do. We know all fillings eventually need replacement, so we encourage getting the most out of the existing fillings if possible.

For this patient, we discussed the pros and cons of replacing all three silver fillings ...

Discolored, stained, and decayed front teeth can be embarrassing, but thankfully we have many different ways to help restore your confidence and repair your teeth. 

This patient had decay and discoloration close to the gum line with an older tooth colored filling that was discolored. We removed all the decay, white spots, and previous filling. Then repaired the front teeth with tooth colored filling material. 

Contact us today to schedule your appointment!

Sensitivity to hot, cold, and sweet can all be signs of a tooth decay. The decay could be under an existing filling or crown, or it could be a new cavity between two teeth. This patient one new cavity that had grown to the point of trapping food between the teeth. They also had decay forming under an existing silver filling. 

We used a rubber dam to protect the lips, cheeks, gums, and prevent the patient from swallowing dental tools. Wedges were used to separate the teeth and further protect the gum tissue. 

Then we removed the decay and existing filling. The ...

There are many reasons for needing a crown including a large failing filling and cracks extending through the enamel and into the middle of the tooth.

This patient started with a very large silver (amalgam) filling on their upper premolar. The silver color was causing the tooth to appear grey. It also had large cracks extending under the silver filling. 

We first removed the silver filling and built the tooth back up to normal size using a tooth colored filling material. This can work well for a short time, however due to the crack we were concerned about the tooth breaking over ...

One of our adult patients noticed she was frequently getting food caught on the chewing surfaces of several molars and was worried about getting a cavity on her teeth. We recommended a sealant to help protect the pits and grooves of her molars and prevent her from developing a cavity. 

No anesthetic was required and the procedure took less than 10 minutes at a routine checkup and professional cleaning.

While Dr. Appel applied the sealants for this patient, all of our clinical staff are trained to provide quality, long lasting sealants that can minimize the risk of developing a cavity in the ...

Stains can appear over time along the edges of existing cosmetic bonding, fillings, veneers, and crowns. Our patient was concerned about the staining on her front tooth and the small chip on the adjacent tooth. We removed the existing bonding and stain, then replaced with new bonding while also repairing the chipped tooth.

This young college student wasn't happy with the metal crown on her first molar. She previously had a root canal on the tooth and was too young to have a tooth colored crown. The metal crown was leaking and had decay underneath which infected the root canal for a second time. We were able to partner with an endodontist to clean the root canal again (retreatment) before replacing the crown with a custom porcelain layered on zirconia crown. Our laboratory did a wonderful job matching the adjacent teeth and delivering a crown that blends in beautifully with her smile.

Our patient had a previous tooth supported bridge that failed. We decided to replace the failed bridge and missing teeth with an implant supported bridge. First, we removed the roots of the decayed teeth and placed a bone graft. Once the bone graft healed, we were able to place two dental implants to replace the missing tooth roots. The dental implants healed underneath the gum tissue for several months. Once the dental implants were healed (integrated), we uncovered them and placed a temporary implant supported bridge. The temporary implant supported bridge helped shape the gum tissue around the implants and ...

This patient came in for a checkup and we noticed there was an open space with decay around an old filling. We were able to remove the previous filling and the decay, then repair the tooth with a new tooth colored filling that blends in naturally.

Our patient was having sensitivity on several teeth while eating and drinking sweet things. We found several large cavities in the pits and grooves of her molars. We used a green dental dam to isolate the teeth and prevent anything from contaminating the teeth. We then removed the cavities and rebuilt the teeth using white, tooth-colored composite filling material. We adjusted the bite after removing the dental dam and polished to make sure there were no rough areas. These fillings should last a long time with excellent home care and routine cleanings.

Careful walking with your hands full! Our patient was carrying a Yeti mug and tripped, hitting her tooth on the straw. We were able to see her right away and completed an emergency repair of the tooth with composite filling material.

This patient has worn a denture for many years, but grew tired of the bottom denture moving, coming out, and having difficulty speaking and eating. We planned his implant placement using a 3D x-ray and a scan of his mouth. Two implants were placed and locator attachments were used to connect a new denture to the implants. Now his denture snaps into place, is much more stable, doesn't come out while speaking or eating, and is much more comfortable. He was even able to eat corn on the cob!

Our patient was concerned that her smile was not bright enough. After one session with our Zoom In-Office Whitening system we were able to give her the bright smile she was looking for!

Yes, fillings do wear out over time! After almost 10 years, this filling was discolored and leaking around the edges. The old filling and decay was removed, then a new filling was placed.

This patient came to us because she was trapping food between two of her back teeth and she didn't know why. She had two failing composite restorations that had too much space between them and were also stained, leaking, and had decay underneath them. We used a soft green rubber dam material to protect the gums, cheeks, lips, and tongue and to isolate the teeth for better adhesive bonding. We removed the old fillings and the decay and replaced them with new fillings. The teeth are now touching so she no longer traps food between them!

This patient came to us looking for a way to improve her smile and give her the confidence she needs for some upcoming job interviews. It was short notice, but we made molds of her teeth and had one of our lab partners design a custom fitted Snap-on Smile. It fits on top of her existing teeth and "snaps" securely into place. It does need to be removed for cleaning and is not intended for long term use. Fingers crossed on the job interviews!

This patient had direct composite veneers on his front two teeth and unfortunately one of the veneers chipped. We removed the remaining veneer and replaced it with a new direct composite veneer. We had him smiling again after just a few minutes in the chair!

Oh no, I chipped my tooth! It can happen to anyone at almost any time. It can be especially scary when it's a front tooth. We roughened the tooth and applied some white composite resin, then shaped it to match this patient's smile.

Our patient was unhappy with the color of her teeth and wanted a brighter smile! She came in for a 60 minute bleaching session with our Zoom in-office whitening system. We helped her achieve an 8 shade improvement in the color of her teeth with 3 cycles of light activated bleach. We also made custom bleaching trays for home use to help her maintain the brighter smile for many years to come!

This patient recently moved to town and was having severe pain on biting and while drinking cold things. She had two white composite fillings placed the year before, but they were already showing signs of discoloration and leaking. We used something called a rubber dam to protect the cheeks, tongue, gums, and lips. The rubber dam also allows us to maintain a very clean tooth surface in preparation for adhesive bonding of new composite fillings. The patient has been pain and sensitivity free ever since we replaced the composite fillings!

This patient chipped her front tooth which had a previous white composite filling repair. We removed the old tooth colored filling material and replaced it with a new tooth colored composite filling. We also adjusted the bottom teeth to prevent them from hitting the filling too hard, which could lead to another chipped filling or tooth.

Our patient had a previous amalgam (silver) filling on a molar. The silver filling developed a crack and also had gaps between the silver filling and the tooth allowing bacteria to leak underneath the old filling. The patient also desired a tooth colored replacement option. We were able to remove the old silver filling and replace it with a white composite filling.

Our patient was unhappy with the dark appearance of her two front teeth. There are many different options for whitening teeth including bleaching, ceramic veneers, or direct composite veneers. Our patient decided on direct composite veneers. We removed any old filling material and roughened the surface of the teeth. Then we adhesively bonded white composite resin to the teeth and shaped it to blend in beautifully with her smile.

Sometimes a filling is simply not strong enough to repair a tooth. This patient had an old filling with a crack underneath. It was causing her pain when biting. The old filling was removed, then the tooth was rebuilt and prepared for a crown. The crown preparation removed about 1 millimeter 360 degrees around the tooth and a few millimeters off the top of the tooth to allow space for the crown material. An impression was made of the tooth and sent to a laboratory to fabricate a custom fitted crown for the tooth. The patient went home with a temporary ...

Cavities often can be found in the pits and grooves of our molars. They can appear chalky white or shades of brown. The texture of the cavities is often soft, sticky, or sometimes mushy. When the doctor is checking for cavities they use an instrument called an explorer to feel the texture of the pits and grooves. If the explorer "sticks" or "catches" in a pit or groove and the groove appears discolored, then it likely has a cavity. Often a sealant can be placed as a preventative measure to protect the healthy pits and grooves of the teeth.

Oops! This young patient fell out of bed and chipped his front tooth. After isolating the tooth with a dental dam, we roughened the tooth up and smoothed the chipped area before rebuilding the chip with white composite filling material. Composite can be an excellent material because it can easily be repaired if he ever chips the filling or tooth again.

Our patient flew in from out of town to have this filling replaced. The edges of the filling were starting to leak, allowing bacteria to damage the tooth underneath the filling. A dental dam was used to isolate the teeth. We removed the old filling and replaced it with a new tooth colored filling.