Our Services

Age Related Services

Children

The focus on young children must be preventative. Dr. Koveos and his team strongly believe that this is the time to teach children the proper way to clean their teeth, to teach them what causes cavities, and totally prevent disease from happening in the first place. This will ensure that as they grow older, the will have far fewer problems, and less invasive treatments.

Typical treatments for young children would include prevention techniques, routine cleaning of the teeth with examinations, nutrition counseling, fluoride treatments, sealants and cavity repairs.

Teens/Young Adults

This tends to be one of the healthiest groups of patients. If they are doing their preventative maintenance, they should have few cavities and no gum disease. If they do have disease, we spend a lot of time teaching them the value of taking care of their teeth before we fix them. This age group is prone to bite related issues, including TMJ. This is when they usually undergo orthodontic care to help them look better, and make their bites better. We also provide tooth whitening procedures, cosmetic bonding, and veneers to make their appearances better.

Adults

The adult stage of life needs many of the services that we provide. Unfortunately, our bodies start to change, and are not as resilient to disease. Periodontal disease starts to happen if proper home care is not adhered to. This can range from moderate to severe. Some of the dentistry that was placed as a child or young adult is starting to break down and needs replacement. Most adults want their old silver fillings removed, and replaced with tooth colored fillings that blend in with their teeth. The long-term affects of malocclusions start to show, including cracked teeth, broken teeth, worn teeth, shifting teeth and TMJ problems.

It is also the time in life where adults become concerned about their appearance. Tooth whitening, cosmetic dentistry, and extreme smile makeovers are sought after by adults to make their appearance more youthful and beautiful. This is often combined with eating healthier, exercise, and other cosmetic procedures to look your best. This is where Dr. Koveos has searched for the best education possible, to give you the best results possible.Most adults choose to have major dental work done at this age, because it makes them feel good about themselves, and they can afford the treatment.

Seniors

As our population continues to age, taking care of Seniors will be one of dentistry's biggest challenges. Early seniors need repair of old restorations. Often, these old restorations are very large, and need crowns to protect the teeth. Many seniors did not have the advantage of prevention based dentistry when they were younger, which means that they suffer from advanced periodontal disease, tooth loss, and advanced malocclusions. They often need crowns to protect teeth, and replacement of missing teeth with bridges, implants, partial dentures or full dentures. Much of the dentistry that had been done in the past may need replacement. Seniors have functional problems that interfere with the harmony of the muscles, teeth and jaw joints. This leads to jaw problems, broken teeth, sore muscles and worn teeth.

Most seniors realize the importance of being able to chew properly to get proper nutrition, which is essential to staying healthy and avoiding digestion problems. Seniors also seek cosmetic services, such as tooth whitening and extreme smile makeovers to make them look and feel younger.

Prevention of Disease

One of the most important aspects of good dental care is the prevention of disease. So many times, dentists and patients only repair problems when they arise, and do nothing to prevent the recurrence of disease again. The foundation of our practice is prevention. We teach every patient the proper way to take care of their teeth, and encourage them to do so. That way, any dental work that needs to be done will last longer, and ultimately, the patients will need to see us less. We also ensure that you receive the best diagnostic services possible, including periodontal charting once a year, and routine x-rays. All of our prevention services are tailored to the individual needs of the patient. When we achieve true health in your mouth, you will only need to see us once a year for your recare visit and exam. This is the ultimate goal that we set for each of our patients. Other patients need to be seen on a more frequent basis, in six, four and three month intervals.

Periodontal Disease

Periodontal disease is the leading cause of tooth loss in adults older than 40. It is also the most preventable disease known to man. It starts innocently as Gingivitis, or a swelling of the gums. This is common in teenagers and young adults. As patients reach their 30’s, it can progress to moderate Periodontitis. If left untreated, it can become advanced in the 40’s, and severe in the 50’s and above. It is caused by bacteria that live below the gum line, and between the teeth, where a toothbrush cannot reach. The bacteria release toxins, which cause the body to send chemicals to the sight to defend itself, called inflammation. Unfortunately, chronic inflammation destroys the ligaments and bone that support the teeth. The bone loss is irreversible. The bone reacts to inflammation much like a patient who has arthritis. In advanced and severe periodontal disease, the teeth loosen or get infected, and are lost. Most patients who have dentures lost their teeth to periodontal disease that was not treated or controlled. There are other factors that can cause the disease to progress more rapidly. These include individual immune responses, patients with diabetes, poor nutrition, immuno-compromised patients and smoking. We screen for periodontal disease at least once a year on all of our patients, and recommend the appropriate treatment when necessary.

Healthy	Gingivitis	Moderate Bone Loss	Severe Bone Loss

We always offer non-surgical treatments first, which can be very effective on Gingivitis, moderate and advanced Periodontitis. We start with a Soft Tissue Management program which removes all the offending bacteria and tarter above and below the gum line, which are the cause of the disease. Our office uses the best ultrasonic scalers possible, which release medicines under the gum line as well. This removes bacteria and disinfects the tissues. This is a very comfortable process. Along with active treatment, patients are taught the best way to remove the bacteria on a daily basis, which will allow the mouth to heal and prevent future disease. There are then follow-up procedures after active treatment to assess the success of treatment. If there are any remaining areas of disease, we use locally delivered antibiotics called Arestin. Some patients with more severe disease are placed on a long-term low dose of tetracycline called Periostat. This actually does not act as an antibiotic, but is prevents the harmful affects of the inflammation response to the bacteria, which causes destruction of the ligaments and bones.

There are instances in advanced to severe periodontal disease that need surgical treatment. We only recommend this when necessary, and try to prevent this from ever needing to be done. Periodontal disease has been linked to other diseases in the body besides the mouth. Due to the inflammation chemicals that are chronically release, other areas of the body can react as well. These include the liver, kidneys, arthritis and especially the risk of coronary heart disease. The importance of prevention and proper home care can not be overstated.

Healthy	Bone Loss	Healthy	Bone Loss

Mercury Free Fillings

Dr. Koveos no longer places Amalgam fillings, which contain mercury. To this date, their has been no absolute link between the small amounts of mercury that are slowly released over time to health problems. However, research is still going on, and we really don't know for sure that it is 100% safe.

The reason that Dr. Koveos does not use silver fillings is that when it sets, it automatically expands like cement, which causes stress from within the tooth. This leads to cracking or breaking of the tooth later in life, requiring a crown to fix it. The bonded composite fillings blend in with the rest of your tooth, and actually strengthen the tooth because of the bond. It also prevents the unsightly “leaking” of the silver filling, which makes teeth appear black through the enamel.

Examples of teeth broken & Cracked from Mercury Fillings

Tooth Whitening

Have you ever seen someone with a great smile? Have you ever asked yourself if you too could have a white beautiful smile? Now you can with Brite Smile, the leading In-Office Whitening system on the market today. Brite Smile is a revolutionary technique for enhancing your smile to make your teeth sparkle! Dental Visions is an authorized practice to perform the Brite Smile Procedure in this area. All it takes is an hour after a barrier to protect your gums is applied, and you will have white teeth that are up to 10 shades lighter!

Teeth bleaching or whitening lightens the color of teeth whether darkened from age, coffee, tea or tobacco. Its brightening effects can last up to five years after the treatment depending on how much you drink coffee, tea, red wines or smoke. Bleaching is tough on stains but gentle on your teeth! Results vary depending on several factors. Teeth stained from age, tobacco and wines have the highest success rate. If teeth are stained from medications such as tetracycline during tooth development; or from fluorosis, a condition occurring in the presence of too much fluoride, the Dr. will let you know what the expected results would be. Bleaching will not lighten fillings crowns, porcelain veneers, etc. Dr. Koveos may suggest not getting treatment if you have sensitive teeth, periodontal disease, teeth with worn enamel or if you're pregnant or breast-feeding.

Dr. Koveos will examine your mouth to make sure that you are a good candidate for whitening. Any cavities or gum problems must be treated before the whitening process can be started. Brite Smile typically takes 2 hours for the entire process, with one hour of actual treatment with the whitening agent and the light. Your change will be noticeable and immediate. After completing the treatment, the Dr. will check out the results with you. You will be instructed not to eat or drink anything dark, especially red wine, for the first 24 hours after treatment is completed. Also, smoking in the first 24 hours will decrease the whiteness dramatically. When you leave the Dental Visions office, you will feel good, look good and have the smile you've always wanted.

All Porcelain Crowns

Examples of a tooth restored with a crown

Veneers

Many patients are very familiar with veneers. They have come to light, especially on shows like “Extreme Makeover”. Veneers are a valuable tool when minor tooth shape changes are needed, as well as permanent color changes of the teeth. They are especially valuable when teeth are stained from tetracycline or fluorosis. The preparations for veneers can be conservative, however, the thicker the porcelain is, the better they look. Currently, there is a move in dentistry to perform “no prep” veneers. This may seem like a good idea, but in most cases, it is not. It just simply will not as beautiful or natural as it could be.

The advantage of veneers is that it conserves tooth structure. Unfortunately, veneers should not be used when major changes are necessary or when teeth are worn. They will most likely break under these circumstances.

Before Veneers	After Veneers

Replacing Missing Teeth

Fixed Bridges

Bridges are used to replace a missing tooth, or several missing teeth. Teeth in on both sides of the space are prepared, and are used to support the replacement tooth. This is cemented in place, and does not need to be removed. A bridge is especially useful when the teeth on either side of the bridge have large fillings or need crown coverage for protection. Bridges are harder to maintain, because the teeth are connected, but if well maintained, they can last for a long time.

Before Bridge	After Bridge

Implants

Dental implants can be used for many reasons. One of the easiest is replacement of one missing tooth. They can also be used to replace lost back teeth, where a traditional bridge can not be used. A titanium dental implant is placed by an oral surgeon, and is allowed to heal. The jawbone essentially fuses to the implant, which is called Osseo integration. Once the implant is fused to the bone, an attachment called an abutment is placed on the implant post. A traditional crown can then be placed on it. Implants can also be used to retain partials or full dentures. They can greatly enhance the quality of life with these prosthetics.

Different Uses for Implant Therapy

Partial Dentures

Partial dentures can also be used to replace teeth. They are particularly useful when many teeth are missing, because partials are a more economical solution to replacement of teeth with bridges or implants. Partial dentures are removable, which definitely makes them feel foreign. Partials do a great job at replacing many lost teeth, and to increase chewing power. In some cases however, patients can find it difficult to get use to them.

Complete Dentures

Complete Dentures are used when all of the teeth are missing in an arch, or when most of the current teeth can not be saved. In the past, dentures were not only acceptable, but often inevitable. Today, dentistry focuses on prevention of disease and preservation of teeth. Fortunately, the use of implants for retaining ill fitting dentures has change the life of many denture wearers.

Repair of Worn Dentition

This is one of the most ignored areas in dentistry. This is because of the complexity and difficulty in fixing the worn teeth. Wear is often caused by grinding of the teeth, or having unhealthy bites. Dr. Koveos is a true believer in preventing wear of the teeth in the first place in order to prevent his patients from needing extensive and costly work later in life. A dentist who works on these cases to restore the teeth to their “original” condition needs many extra hours of continuing education at the right institutions. Dr. Koveos has received extensive training at both the Dawson Center for Advanced Dental Studies, and Orgnathic Bioesthetics International. He is aware that you have to address what is causing the wear before fixing the teeth, otherwise they will break or wear again. Patients who have their worn dentition fixed not only look better, but also chew much better. They can now eat foods that they had to avoid in the past, which makes for better nutrition and better digestion.

Examples of a exessive wear and final restoration of teeth

Extreme Smile Makeovers

The television show “Extreme Makeovers” has shown many Americans what dentistry can offer. There has been an explosion in cosmetic dentistry over the past 4 years. Sometimes, patients have purely cosmetic reasons for wanting to change the appearance of their smile. Often times, small changes can be made with veneers. Sometimes whitening or some cosmetic bonding can be done to improve a smile. Other times, cosmetic problems are a sign of some underlying bite disease such as wear and grinding. Often, cases can be more complex, involving braces (orthodontics or Invisalign), gum “plastic surgery” (periodontics/oral surgery) or even surgery of the jaws or face. When done improperly, cosmetic dentistry can have negative affects on the other teeth, especially in the back. Again, it is better to have this type of work done by a dentist that has extensive knowledge of the bite, and its harmony with the muscles and joints. Dr. Koveos has this knowledge.

Examples of extreme smile makeovers