Your initial consultation visit will last about one hour. Please bring the completed patient information forms that you received prior to your appointment with you. In addition, please bring any radiographs and any other pertinent dental information from your past dentist or dentists. 

During this first visit, you will meet with Dr. Chaffee. She will discuss with you your past dental history and your current dental problems. She will complete a brief examination. If you brought x-rays from your previous dentist, depending upon the type and age of the x-rays she will determine whether additional ones will be needed to properly diagnose your situation. Depending upon the complexity of your situation, impressions of your mouth may also be completed to assist in developing a plan for your dental treatment. 

Some patients will need to be referred to additional specialists such as periodontists (specialists in treating gum disease), endodontists (specialists in treating root canals), or oral surgeons. Once Dr. Chaffee has collected the information needed, she will develop treatment plan options for treating your dental condition. Depending upon the complexity of your situation, she may present this at the conclusion of the first visit or may need you to return for a second appointment to discuss the plan with you. 

Once you and Dr. Chaffee have determined the best plan of treatment, you will be provided a copy of your treatment plan that outlines the fees for the services planned. Then the number of appointments and the sequence of treatment will be reviewed with you and the appropriate appointments made. 

Your initial consultation visit will last about one hour. Please bring the completed patient information forms that you received prior to your appointment with you. In addition, please bring any radiographs and any other pertinent dental information from your past dentist or dentists. 

During this first visit, you will meet with Dr. Chaffee. She will discuss with you your past dental history and your current dental problems. She will complete a brief examination. If you brought x-rays from your previous dentist, depending upon the type and age of the x-rays she will determine whether additional ones will be needed to properly diagnose your situation. Depending upon the complexity of your situation, impressions of your mouth may also be completed to assist in developing a plan for your dental treatment. 

Some patients will need to be referred to additional specialists such as periodontists (specialists in treating gum disease), endodontists (specialists in treating root canals), or oral surgeons. Once Dr. Chaffee has collected the information needed, she will develop treatment plan options for treating your dental condition. Depending upon the complexity of your situation, she may present this at the conclusion of the first visit or may need you to return for a second appointment to discuss the plan with you. 

Once you and Dr. Chaffee have determined the best plan of treatment, you will be provided a copy of your treatment plan that outlines the fees for the services planned. Then the number of appointments and the sequence of treatment will be reviewed with you and the appropriate appointments made. 

 
Your First Visit

Your initial consultation visit will last about one hour. Please bring the completed patient information forms that you received prior to your appointment with you. In addition, please bring any radiographs and any other pertinent dental information from your past dentist or dentists. 

During this first visit, you will meet with Dr. Chaffee. She will discuss with you your past dental history and your current dental problems. She will complete a brief examination. If you brought x-rays from your previous dentist, depending upon the type and age of the x-rays she will determine whether additional ones will be needed to properly diagnose your situation. Depending upon the complexity of your situation, impressions of your mouth may also be completed to assist in developing a plan for your dental treatment. 

Some patients will need to be referred to additional specialists such as periodontists (specialists in treating gum disease), endodontists (specialists in treating root canals), or oral surgeons. Once Dr. Chaffee has collected the information needed, she will develop treatment plan options for treating your dental condition. Depending upon the complexity of your situation, she may present this at the conclusion of the first visit or may need you to return for a second appointment to discuss the plan with you. 

Once you and Dr. Chaffee have determined the best plan of treatment, you will be provided a copy of your treatment plan that outlines the fees for the services planned. Then the number of appointments and the sequence of treatment will be reviewed with you and the appropriate appointments made.

 

Treatment Options

The following is a listing of the types of restorative treatments offered at the practice.

  • Crowns – All Ceramic, Porcelain-Fused-to-Metal, and All Metal

  • Bridges – Conventional and Resin-bonded (Maryland) to replace missing teeth

  • Implants – Single Tooth Replacement and Multiple Tooth Replacement

  • Complete Dentures – Conventional and Implant Retained

  • Partial Dentures – Metal-Base

  • TMD-Jaw Joint Problems – Bite Splint Therapy and Bite Adjustment

  • Veneers – Porcelain and Direct Composite Resin Bonding

  • Full Mouth Reconstruction – Crowning all the remaining teeth

  • Sleep apnea appliances—Following referral from a physician

Dental crowns are a restoration used to restore a tooth that has broken, is cracked, has extensive tooth decay, has large existing restorations or is not in the correct position.  Crowns can be made of metal, porcelain fused to metal, or all ceramic materials like Zirconia. 

 

The procedure to make a crown typically takes two appointments and involves preparing or drilling the tooth to remove just enough for thickness of the restorative material, making an impression with either material in a tray that takes several minutes to set or with an intraoral scanning device to make a digital image of the tooth, and making a temporary crown that is worn while the definitive crown is made at the laboratory, and finally delivery of the final crown about 2-3 weeks later.  Final delivery of the crown involves ensuring that it fits correctly to the tooth and that the bite or occlusion is adjusted properly. 

Crowns
 
Bridges

Dental bridges are a restoration used to replace a missing tooth or teeth.  A conventional bridge involves crowning the teeth on either side of the missing tooth/teeth with the replacement teeth connected to these crowns. 

 

Another type of bridge is a resin-bonded bridge, also known as a Maryland bridge.  It involves removing a minimal amount of tooth structure off of the teeth next to the missing tooth/teeth to allow the replacement teeth to be bonded to the support teeth.  This type of bridge is used in young patients who may be missing a tooth because they never got the permanent tooth (congenitally missing).

 

Dental implants are an option to replace a missing tooth or multiple teeth.  Implants are typically made of titanium and have special coatings to promote bonding to the bone.  If a single tooth is missing, the implant is placed and once it bonds to the bone, an abutment is screwed into the implant and a crown is made that is cemented onto the abutment.  If several teeth are missing, multiple implants can be placed and a bridge used that is supported by the implants.  These bridges can be cemented to abutments or screw-retained.  A screw-retained bridge allows the restoration to be removed if the porcelain chips or if there are problems in the gum tissues.  If a patient is missing all the teeth in an arch, implants can also be used to replace the teeth with either bridge work or to stabilize a removable denture using special attachments or “snaps”. 

Whenever implants are used to replace teeth, several steps are required.  First, special images are required to evaluate the height and width of bone available.  Today, CT scans are used for most cases.  The CT scan can be used to plan where to place the implants and to create surgical guides to allow the surgeon to accurately place the implants so that they can be restored. If there is not enough bone, then bone may need to be grafted to create enough bone to allow an implant to be placed.  Planning for implant placement is a critical step to create a final result that is functional and esthetic. 

Once implants have been placed, they must have time to heal and form a bond to the bone.  This bond, which is called integration, takes a minimum of 8 weeks to form.  Once the implants have integrated, the next step is to place a provisional or temporary restoration to mold the gum tissues to create a natural looking tooth.  When the tissues are healed, an impression or digital scan must be completed and then the final restoration is made.

There are times when we can immediately load or restore an implant with a provisional or temporary restoration the same day it is placed.  This is not for every case and must be carefully planned.

 
Implants
Complete Dentures

Complete dentures or “plates” are used to replace an entire arch of missing teeth.  They are removable appliances.  Most patients do fairly well with upper dentures however lower dentures are typically problematic.  Complete dentures are about 1/6 as efficient for chewing as natural teeth.  They are replacements for no teeth.  Complete dentures can be used with dental implants to aid in retention and stability of the appliance. 

 

Most dentures today are made using acrylic resin or plastic denture teeth held in a pink or gum colored acrylic resin.  Plastic denture teeth are susceptible to wear as well as to erosion from stomach acids, especially in patients who have reflux.   As such, dentures do not last forever.  Constructing a complete denture typically takes 5 appointments.  They are custom fit to each patient to create a functional and natural appearance.

 

Partial Dentures are used to replace multiple teeth but not an entire arch of teeth with one appliance.  The best type of partial denture has a metal base that allows the appliance to clasp to the remaining natural teeth and be supported both by the teeth and the gums.  They are a cost-effective way to replace multiple teeth. 

 

Partial dentures also do not last forever but can often be modified to add teeth or clasps if more teeth are lost.  Constructing a partial denture can take as few as 3 appointments or up to 5 appointments.

 
Partial Dentures
Veneers and Direct Bonding

Veneers and direct bonding are used to improve the appearance or alignment of teeth. Veneers are typically made of porcelain material and require some preparation of the tooth.  Veneers typically take two appointments, the first to prepare the teeth, make a final impression or digital scan, construct temporary veneers and the second to remove the temporary veneers and deliver the final porcelain veneers that are made by a dental laboratory. 

 

Direct bonding can be done in a single appointment.  It requires great artistic skill to create an esthetic result.  Direct bonding is usually used for younger patients to preserve the tooth structure.

 

A full mouth rehabilitation involves the restoration of all the teeth at the same time.  This type of treatment is incredibly complex. Prosthodontists spend three years in training after graduating from dental school to learn how to restore the whole mouth.  It may require the collaboration of additional specialists including periodontists, endodontists, and oral surgeons.  It requires significant planning and multiple steps to complete.  In addition, it is a great financial investment in overall health and can dramatically improve a patient’s appearance.

 
Full Mouth Reconstruction
Sleep Apnea Appliances

Sleep apnea is a significant health issue today.  Oral sleep apnea appliances can be used to treat mild to moderate sleep apnea.  They are successful in 60-70% of cases.  They work by repositioning the lower jaw forward to prevent the tongue from being able to fall to the back of the throat and close off the airway.  They can be used in patients who have no jaw/joint dysfunction and who have teeth.  Patients must be referred by their MD/ENT who have already diagnosed their apnea and performed the testing prior to constructing an oral appliance.

 

TMD stands for temporomandibular disorder and is also known as TMJ.  Patients with jaw dysfunction may have headaches, jaw opening problems, pain, and bite problems.  Patients who have significant TMD problems should seek treatment from a dentist who has additional training and have been certified in TMD/Orofacial Pain. 

 

Patients who begin having problems immediately following dental treatment by their general dentist can often be treated conservatively using a bite guard and minor bite adjustment once their symptoms are eliminated.  Bite guards are often prescribed for patients who clenching and/or grind their teeth at night.

 
TMD-Jaw Joint Problems
Follow Up

Throughout your treatment, we will be in contact with the provider(s) who referred you to our office. Once your treatment has been completed in our office, you will either be referred back to your general dentist or periodontist or will be followed by our office for your cleanings. It is our desire to help you maintain your investment in your dental health, therefore, we will try to work out the arrangement that is in your best interest for your continued dental health. 

 

Welcome to Apex Prosthodontics

919-387-4775