Bridges are constructions,which consist of abutments(crowns, inlays, onlays) and false teeth(pontics). They can be constructed either on natural teeth or on implants. On the natural teeth they are usually permanently cemented, while the bridges on implants could be either cemented or screwed down.

Routine Hygiene visits include: -Complete examination -Thorough cleaning -Periodontal examination and measurements -Oral cancer screening -Diagnodent survey (laser cavity detector) -Needed x-rays to screen for tooth decay, cysts, and bone loss

When the patients particular situation necessitates they are referred to the Specialists, who limit there practice only to the certain field. For complicated root canal re/treatment we refer to Endodontist. When there is significant loss of gingival tissue,perio-bony defects, uneven architecture of the aesthetic gingival zone, etc. we refer to Periodontist. For removal of the impacted(below the level of bone)wisdom teeth, Bone augmentation(adding on)- creating the bony site for implant placement, multiple complicated implants placement, surgical trauma, removing of tumors, orthognathic(correcting jaws discrepancies), joints distruction,etc. we refer to oral/maxillofacial surgeons. For comprehensive orthodontic treatment(correction of malposition of the teeth)with "braces", "invisalign", etc. we refer to Orthodontist.

The "cavities" are the sites of decay inside the teeth caused by the acid-producing microbes. The decay can form in the deep grooves on the chewing surfaces or in the contact areas between the teeth where the plaque and small food particles are trapped.

Often for the small kids the inhalational Nitrous Oxide Sedation ("Laughing Gas") is very helpful. It is also often helpful to suppress the gagging reflex in adults. Intravenous Light Conscious Sedation is one of the best methods of helping the patients with otherwise uncontrolled gagging reflexes, with uncontrolled fear, apprehension, and making long appointments much better tolerable for regular patients.

The crowns are either 3/4(partial) or full coverage restorations on natural teeth or only full coverage - on implants. They can be constructed from acrylic material(usually as provisional), only metal, porcelain fused to metal (PFM - the metal can range from high noble to base-metal), all-porcelain(porcelain baked on special CAD-CAM fabricated coping),or thin porcelain(Jacket) crown.

Implants are artificial fixtures,which are embedded inside(blade-form, root-form, transosteal-staple-form) or on the top of bone(subperiosteal). The most popular currently are root-form implants. The bone cells grow into the oxide layer of the Titanium or Titanium alloy implants, which become ankylosed inside the bone. This process had been named osteointegration. The implant insertion can be done as one-stage or two-stage surgery, depending on different factors. The prosthetic appliance can be later attached directly to the implant or through implant(transmucosal) abutment. We have extensive training, expertise and experience in restoring both simple and comprehensive implant cases, as well as in not complicated surgical placement of implants.

In some instances teeth arrangement can be affected by bad habits(tongue thrusting, finger or lip sucking,etc.)usually in kids, or premature primary teeth loss. In adults some anterior teeth can be lightly malpositioned or posterior teeth shift,tilt and supererupt toward previously lost and not restored for a long time teeth, etc. In such instances we can fabricate and insert appliances for minor teeth movement.

Inlays/Onlays are called microprosthetics. In the case when there is loss of tooth structure(due to decay or failed previously placed chair-side restorations)when the restorative area of the tooth takes more then 1/3 of the width of the tooth it is generally recommended to restore the tooth with the lab fabricated Gold, porcelain or special composite inlay/onlay. Those restorations do not harm the teeth by polymerization shrinkage as it is seen in the chair-side polymerised composite restorations.

The range of Soft Tissue Laser procedures. Periodontal health(the health of bone and gum around the teeth) is crucially important for the health of the teeth as well as different organs and systems in the human body. In fact recent studies proved that there is connection between heart disease, obstetric problems and poor periodontal condition. It is well researched and proven that periodontal disease is caused by aggressive bacteria growing into periodontal spaces and creating periodontal pockets(deeper than 3 mm.) Poor oral hygiene and contributing factors(smocking, uncontrolled diabetes, some anti-convulsive, high blood pressure and heart medications)and genetic factors are blamed as the cause of Periodontitis. We use comprehensive conservative approach for controlling periodontitis: under local anesthesia the sites are laser decontminated, mechanical debridement is being performed(scaling and root planing),then the laser curetage is performed, the pockets are irrigated with antimicrobial mouthwash, and if they are 5+ mm.deep, we place periodontal chips(local chemotherapeutic agent which dissolves during 10-12 days).The patients are also prescribed bone-specific antibiotic, antiinflammatory medication, and topical antimicrobial rinse and desensitising gel.

The patients with the healthy gums and bone should brush their teeth at least twice a day and floss between the teeth and under fixed prosthetics at least once a day(proper instructions are usually given at the dental office); they should regularly visit the dentist at least every 6 months. The patients with diagnosed periodisease should use at home additional means recommended by their dentist or periodontist, and they should visit their practitioner of choice at least every 3 months.

One of the possible choices of restoring missing teeth is removable partial denture, especially when fixed restorations are not indicated or not feasible. Removable dentures can be attached for retention and support to the natural remaining teeth by conventional connectors(retentive-stabilising-resting arms, hooks). In some cases, when crowning of the abutment teeth is indicated the denture can be attached to those crowns by different precision attachments, which mechanically and cosmetically are advantageous in comparison with the regular connectors. These are the precision attachment combined cases. Some patients are completely edentulous or at least couple teeth can be saved on the lower jaw. In such cases the upper complete denture can be constructed, which usually is sufficiently retentive, and the lower remaining teeth can be root canal treated, restored with special posts and connected to the lower denture for retention with special attachments. In the case of complete lower edentulism minimally two implants with attachments for retention of the lower denture are recommended.

When infection,trauma or dystrophic processes are affecting the pulp of the tooth it is necessary to remove the pulp from the roots, clean, shape, and seal the canals with the special materials and technique. This procedure is performed under deep local anesthesia or, if necessary, in addition can be used Nitrous Oxide gas mask or Intravenous Sedation. After performing root canal treatment it is often necessary to build out the tooth with the post/core and restore the wholeness and the anatomy of the tooth with the indicated crown.

Originally introduced sealants had been suggested as very conservative procedure(without actual drilling) for prevention against tooth decay. As it had been clinically proven, in it's original placing technique they created a lot of secondary decay. Thus, currently we use for the same purpose flowable composites with regular placing technique.

Veneers are tooth-coloured facings, fabricated either chair-side from composite resin material or in the Dental Lab from special types of porcelain. These are the most conservative and the most cosmetically attractive restorations, which are usually placed in the anterior segments of the dental arches. The thickness of veneers usually ranges from 0.3 to 0.7 mm, thus the teeth are reduced facially and incisally within the thickness of enamel, minimally traumatising the tooth. Instead, chemically and micro-mechanically bonded to the teeth porcelain veneers actually strengthen the teeth, especially if the teeth had been previously traumatised or restored with extensive composite resin restorations. Life expectancy of veneers can be up to 10-15 years, but it depends significantly on individual habits and maintenance.

Teeth whitening procedures are purely cosmetic and recommended either for healthy teeth or caries free composite resin restored teeth. The whitening can be performed either chair-side(1 1/2 h. appointment) or at home (during 2 weeks), or combining different techniques. In either case we fabricate custom trays for using with desensitizing gel or touch-up home whitening. The effect of whitening usually lasts for 1-2 years, but differs individually depending on habits and structure of enamel.