Smiles by Payet Dentistry is Moving in May!

As we’ve been telling so many of our patients in recent months, we are moving to a new office around the middle of May 2010, and we’re REALLY excited about this!  For a number of reasons, our new office is going to make it so much easier for us to see even more patients, faster, with BETTER customer service than we already strive to offer every day.  Read on for more……..:

• Expanding from 3 Treatment Rooms to 6: We will be dedicating at least 1 of those new rooms strictly to our 6MonthSmiles (fast, invisible braces for adults), because we are seeing so many adults who want a pretty, straight smile, but who don’t want or need to go through comprehensive orthodontics.  In addition, we will be soon adding Tip-Edge Orthodontics for our teen patients, which will make orthodontic treatment for both parents and teens even more convenient.
• Private Consultation Room: Oh how nice this will be.  For a while now, we’ve had to use a converted treatment room for consultations, but it’s never been as quiet and private as we’d have liked.  That’s changing!  You’ll have total quiet and privacy when discussing whatever you need to tell us.
• Kid’s Play Area:  There will be a small area in the Reception are just for kids to play, which will make it so much easier for parents with those small children to keep their appointments.
• Internet Bar + Free WiFi: In today’s interconnected world, it’s so important to be able to stay connected.  We will have a separate WiFi network just for our patients, and the one that we use will be securely encrypted to maintain privacy.  And while we will work to ensure your waits are minimal, if you have a laptop or smartphone….you’ll be good to go.  If not, you’ll still be able to check email or browse the Web from our 3 computers — you can even Share our Facebook Fan page with your friends!  🙂
• TVs in all the treatment rooms: You’ll be able to watch your favorite shows to relax during your appointments with the big 32″ monitors directly overhead.

So stay tuned…….become a Fan on Facebook  for more frequent updates……..exciting times are ahead!

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Complete Smile Makeover with Porcelain Crowns

A Full-Mouth Smile Reconstruction

Quite some time ago, I showed this case as an example of how badly teeth can be damaged by grinding them, whether at night, in the daytime, or both, and why something as simple and inexpensive as a nightguard (my recommendation is a NTI-tss).  It is especially inexpensive in comparison to the cost of rebuilding a smile that is so broken down.  This gentleman came to us in 2008, looking for options to feel good about his smile again for various reasons.  After plenty of discussion, we agreed that the only option that would truly give him the smile that he wanted was a Total Smile Makeover/Reconstruction with porcelain crowns. After showing the Before-After pictures of his smile, I’ll discuss some of the issues you need to consider if you are thinking about significant cosmetic dentistry for yourself.

Frequently Asked Questions about Smile Reconstruction

When rebuilding a smile such as this, it is crucial to establish a proper bite relationship of the top and bottom teeth.  Sometimes this can take a little while to figure out, because – when the teeth are so worn, the patient has long since adapted to a very bad bite relationship.  The muscles have to be relaxed, accurate records taken, and excellent communication is necessary among the patient, the doctor, and the lab, to ensure that the crowns are made to look good, feel good, and last a long time. However, in severe wear cases, we always remind the patient that s/he already did a pretty good job destroying their natural set of teeth, so a nightguard is an absolute requirement as “insurance” to protect their investment, and even then they are more likely to break or chip the porcelain than others who don’t have that history.  Simply put, these cases are far more complicated and require a great deal of time to get right, so you need to be absolutely committed to proceeding and working closely with your dentist to get a good result.

• How Much Does a Smile Reconstruction Cost?

It’s not unusual for a patient to ask why it costs so much to do a Smile Reconstruction like this; it often seems like there should be a “volume discount,” so-to-speak, when doing a lot of crowns instead of just 1 or 2.  The difference between such scenarios is the amount of time involved, the skill, training and experience required to successfully diagnose, complete, and treat, and that your dentist will have to work with a highly knowledgeable lab to make the crowns to not just look good, but fit properly and work smoothly in eating motions.  Your dentist will likely spend at least a couple hours just in the planning stages!  It’s usually a case of “You get what you pay for.”  IOW – if you want a cheap smile makeover, you should reasonably expect a cheap outcome.  To get excellence……it won’t come cheap.  Depending on various factors, a case such as this will be the equivalent of buying a fairly nice car.  The main difference, of course, is that you should expect to be “driving” your smile for a lot longer than most people keep a car!

• How Long Will This Take to Finish?

When doing so many teeth, you need to plan on a minimum of several appointments that could take 1/2-day to a full day each, as well as several other appointments to refine, modify if needed, polish, etc.  From beginning to end, if everything goes perfectly, you might be done in as little as 1 month.  That would be somewhat rare; more likely, you should plan on the entire process taking at least 2 months, and maybe many more.  Extremely complex cases that involve implants, different specialists, and very complicated lab work may take a year or more due to the time needed for healing, verifying each stage is correct, and even just the time needed for lab technicians to do the custom work.

• What kind of Crowns will/should you get?

Due to improving materials and with the right techniques, in most cases nowadays you can have all-porcelain crowns made to rebuild a smile.  The crowns used in this case are made of E.max porcelain, which is extremely strong and resistant to breakage.  Numerous studies now show that this type of porcelain will likely last for 15-20 years, and quite possibly longer.  For certain cases, though, and for patients who are even worse grinders than this gentleman was, gold crowns might still be necessary for the back teeth, simply because they are the strongest, longest-lasting crowns available.  They can also take more abuse than any other material.  Porcelain-to-metal crowns are also an option and have a long track record, but it is very important for the lab to be highly skilled so that you don’t see dark grey lines at the gum from the metal showing through.

• How Do I Choose the Right Dentist?

This is one of the trickiest questions, because the public doesn’t usually know enough about the training necessary beyond dental school that trains dentists to handle complex full-mouth reconstructions with skill and confidence.  But here’s my recommendation: ask to see pictures of their other cases that might be similar to yours.  That’s one of the reasons digital photography is such an instrumental and daily part of our dental practice – you will be able to see similar cases and know how the outcome will be before ever committing.  The large majority of dentists who are well-trained in these cases also use digital photography, both for communicating with you as well as for documenting and tracking their own work over time.  If you meet a dentist who can show you pictures of cases that were completed 5-10 (or longer) years ago AND s/he has recent follow-up pictures to show how well it has held up, THEN you should feel very confident that your dentist can take good care of you.

And then start imagining how much better you’ll feel when you can smile like Wayne does now!

Please feel free to ask questions or post a comment below, or to share with your friends!  If you’re interested in a Complimentary Consultation in our office, please call 704-364-7069 or Request an Appointment Online.

2009 is Almost Over – Use Your Dental Benefits/Flex Plan $ or Lose Them!

USE IT OR LOSE IT!

Your Dental Insurance, that is.  Did you know that, when your dental insurance year runs out, you LOSE whatever benefits you have left?  Unlike phone minutes, there’s no “roll-over” for your insurance, so once they’re gone, they’re GONE.

We are rapidly approaching the end of 2009, and our schedule is already filling up for those last appointments of the year; if you don’t schedule now, you could easily miss out on the opportunity to use your benefits to help you get the dental treatment you need.  If you want to use Flex Plan dollars (‘cause you lose those, too, don’t forget!) or Dental Insurance that is still available, please call Liz at your first chance so you don’t miss out.

END-OF-YEAR SPECIALS

In addition to using your Dental Benefits, we are offering some really cool End-of-Year specials to help you out (hey, if you save some money and I get to stay busy, we BOTH benefit, right?)

1)      Get up to an ADDITIONAL $500 off our amazing Six-Month Braces! This has been incredibly popular, and patients tell us almost every day that they can’t believe how fast their teeth are straightening out.  Many are going to have the smiles straight and white by Thanksgiving or Christmas already.  Since we already have the coupon for $500 off, if you chose this option, you can save UP TO $1000!  If you’re doing 1 arch, you save $250 extra, but $500 off if you do both top and bottom teeth.

2) SAVE YOUR TEETH FROM GUM DISEASE AND $500 OFF! If you have gum disease and we’ve talked with you about LANAP, here’s the best way to go: We are scheduling blocks of time in the last week of December and the first week in January JUST for LANAP patients.  By doing the first ½ of your mouth in Dec., then the second ½ in January, you already get to use TWO years of dental benefits, which will really save you money.  But if you call to schedule now, you can save $500 off your total treatment fee, too!  Because we’re reserving 4-5 hours of time for you this far in advance, we do require a deposit so we know you’re serious. If you’re worried about how it will feel, especially around the holidays, visit us at www.YouTube.com/SmilesbyPayet and you can see some video testimonials from 2 of my recent patients and from other patients around the country.  It’s amazing – all you’ll need is a little ibuprofen and the next day you’re back up to normal .

3) 15% OFF ALL OTHER TREATMENT! Regardless of what other dental work you need, you can save a full 15% off from now through December 31^st.  Just call Liz to schedule your appointment ASAP before others take them all.

So start planning and calling now, before time runs out, your dental insurance is gone, your flex dollars are gone, and our End-of-Year Specials are gone.  We’re looking forward to hearing from you!

Request an Appointment Online or Call 704-364-7069

New tooth-colored fillings sensitive? They should not be!

When most people think of “bonding,” they are thinking of tooth-colored dental fillings, or composite fillings.  To be completely technical for a moment (I try to avoid that as much as possible to not bore you 😉 ), “bonding” is actually the series of steps and the products we dentists use to make the tooth-colored fillings actually STICK to the teeth.  OK – technical moment is over.  Whew, aren’t you glad of that?

An issue that many patients have experienced in the past, is that their new tooth-colored fillings seem to be mildly or even extremely sensitive to cold, and sometimes hot, foods and drinks, even just to tapping your teeth together.  Naturally, it’s not a fun experience, and one that all conscientious dentists try to avoid for their patients, but even in 2009, when one would imagine there is a solution, many patients still run into this problem.  Here’s the thing, though……..THERE IS A SOLUTION!

OK, you’re probably asking, if there’s a solution, why is it still a problem?  Well, it’s simply a matter of technique, really, and getting the technique for bonding is actually more difficult than it might seem to be.  In addition, just as in the rest of the world, there are MANY bonding products that dentists can use when doing tooth-colored fillings, but just because the companies that produce them supposedly have research behind these products, they’re not all they’re always promised to be.  Some work better than others in strength, sensitivity, durability…..and it can honestly be rather tough to sort through all the stuff that companies throw at us, just like for physicians with all the stuff pharmaceutical companies throw at them.  So it is CRITICAL that dentists really stay up on the latest research, but here’s the thing…..just because something has the “latest and greatest, newest and most improved,” labels all over it, that doesn’t mean it actually works as well as the old stuff all the time.

There’s one other REALLY CRITICAL FACTOR for long-term success of composite fillings, and that is keeping the teeth DRY while the bonding is placed and activated, then the filling material is layered into the tooth. Saliva contamination is one of the most common reasons for bonded fillings to be sensitive, and it’s also one of the most common reasons bonded composite fillings fail earlier than they should.  There are a couple techniques dentists can and SHOULD use to do this – a Rubber Dam or something like the Isolite2 Dryfield Illuminator system.  Both are pretty inexpensive for the dentist to have (we have both and use them as appropriate), both are pretty easy to use, and to tell the honest truth, they actually make it EASIER for us to complete your dental work faster and with better results.  I really don’t know why not all dentists use 1 or the other; I can’t imagine practicing without them, ’cause it’s a lot harder to get good fillings!

So there you go: 2 of the most common reasons why bonded, tooth-colored, composite fillings are often sensitive to hot and cold foods/liquids or even just tapping your teeth together.

The good news in our office?  I’m fortunate to actually know the man who basically INVENTED bonding, and I not only use the techniques he teaches, but I even use the most current materials that he himself has developed and/or recommends, and I can honestly say that ALMOST NOONE who gets tooth-colored fillings in my office ever has hot/cold sensitivity afterwards.  There are rare exceptions, ’cause I’m not going to claim perfection, but they’re quite rare indeed.

Quality Dental Plan: Charlotte’s BEST Dental Discount Plan

Thanks to some connections across the country, I am very pleased to announce another exciting development in our dental practice that we truly believe will benefit patients, and that is the Quality Dental Plan, the first nationwide dental discount plan that is truly designed to be AFFORDABLE to both employers and individuals.  In fact, we plan on going out into the small business community to promote this as an affordable way to offer dental benefits to their employees and for their employees to get better dental coverage than with traditional or even PPO dental insurance.  So just how does the Quality Dental Plan work?

For Employers:

Talk about economical and simple to administrate: all you have to do is pay a 1-time annual fee of $345 per employee……AND THAT’S IT!  You have now provided each employee with dental benefits that far exceed what they can usually get from typical dental insurance.  No monthly deductions, no monthly payments, and I’d bet about anything that you will be paying less than you currently pay for your company’s dental benefits.  It COMPLETELY eliminates your administrative work except that all you have to do is let us know if you add or subtract any employees during the year.  THAT’S IT!  And if you want to add a little more value for your employees, you can sign up their family members for ONLY $195 EXTRA PER PERSON!

Theoretical Employer Scenario:
10 Employees x $345 = $3450 annual enrollment.  You’re done.  🙂
Say each employee has 1 family member, so you decide you want to cover them, too.  So 10 family members x $197 = $1970; so now you’ve paid a TOTAL of $5,420 and ALL of your employees and their 1 family member now are members of the Quality Dental Plan and have benefits in our office.  And you’re done!  🙂

Individuals/Families:

If you read the scenario for employers above…..it’s the same idea.  All you do is pay $345 annually to enroll, and you only add $197 extra per family member per year.  So you can enroll a family of 4 for a TOTAL of $936.  So it’s pretty darn simple.

So what do you GET with the Quality Dental Plan?

This is the best part (what you’ve really been waiting for 🙂 ):

• Initial Comprehensive Exam, Complete Set of X-rays, and Routine Child or Adult Cleaning
• At your 6-Month Check-up, you get your Six-Month Exam and Routine Child or Adult Cleaning
• Free Custom Whitening Trays!
• And for the entire 12 months following enrollment, you get 20% OFF ALL OF OUR SERVICES WITH NO ANNUAL LIMIT!

Yes, you read that correctly – 20% off all kinds of treatment. Of course, there are some conditions that go along with the deal, but compared to what so-called “dental insurance” companies offer, they’re insignificant.  So let’s compare the Quality Dental Plan with “dental insurance:”

“Dental insurance” – you only get $1,000-1,500 per year, which has to cover your 2 “free” cleanings/exams/x-rays,  and then you get whatever is left.  Maybe a few fillings or 1 crown, and after that it’s all out of your pocket.

OR

Quality Dental Plan: Your 2 routine child/adult cleanings and x-rays and exams are all included in your enrollment fee, and thereafter 20% off everything with NO LIMITS.   Say you need 5 crowns, well, you get 20% off of each crown, which means that by the time you’ve paid for 4, the last one is almost free when looking at our standard fees.  10 veneers?  20% off!  Six-Month Braces?  20% off! Say you need 5 crowns, 10 veneers, AND Six-Month Braces?  20% off EVERYTHING.

Ok, so you may be thinking, “What’s the catch?  Why does Dr. Payet do this?”  Well, it’s for a few simple reasons:

1. It SERIOUSLY simplifies our administrative work, ’cause we don’t have to deal with insurance companies (that’s reason enough to do it right there, honestly).
2. When you’re able to afford the treatment you want and need, it keeps me busier (my staff much prefers that to me being bored and stir-crazy).
3. It does help you afford the treatment you want and need.

Making improvements and updates

As much as I’ve been integrating some awesome new technology into our practice, I’ve also been working to add useful material to my other practice websites and wanted to make sure people take the time to browse through them, too.  I have 2 more websites that I have to get up and running in the very near future, so be on the lookout, but for the moment, I hope you’ll find these 2 sites helpful:

1. Cosmetic Dentistry in Charlotte by Dr. Charles Payet
2. General/Family Dentistry by Dr. Charles Payet

Before & After Pictures of Another One-Visit Porcelain Crown with CEREC

Interestingly, this porcelain crown was done on the same patient as the last gold onlay that I posted.  So why a porcelain crown on this tooth instead of gold?  Simple — this one is more visible in his smile, and he wasn’t interested in having “bling” in his smile.  LOL  Given that strength and durability of his porcelain crown is also very important, as is obvious by his choice of gold for his second molar on the other side, we did use what is currently the strongest porcelain crown available today, whether made by a lab or with our CEREC, and it is called Emax.  This ceramic is incredibly strong, far superior to the old Porcelain-Fused-to-Gold (PFM) crowns that have been used for decades.  And, of course, we did it in a single appointment.

A CEREC Emax porcelain crown to replace a broken silver filling

Just to review the advantages of CEREC 3D CAD/CAM Porcelain Crowns, and why we’re proud to offer them at our Southpark Charlotte NC dental office:

1. Just 1 Appointment
2. No temporary (provisional) crown
3. No worries about the temporary crown falling off
4. Incredibly strong
5. Very natural-looking and blend in beautifully
6. LESS sensitivity afterward because the tooth is immediately bonded and sealed

If you need a crown and are looking for the convenience and excellent result we can provide with our CEREC 1-visit crowns, call us or visit our website:

704-364-7069

Family & Cosmetic Dentistry in Charlotte NC

Gold Fillings, Crowns, Onlays for Teeth – still the Gold Standard!

When asked what filling or crown material will last the longest, there is a very simple answer that has held true for over a century now, and it is still true today: Gold crowns, onlays, and dental bridges.  Plain and simple, as much as I love doing cosmetic/esthetic dentistry with the ceramic materials available today, I still feel confident that NOTHING will last as long as a gold tooth restoration.

To tell the truth, I haven’t always felt that way, but I’ve come to that conclusion based on 11 years of seeing dental work that works over the long-term.  For many years after graduating dental school, I never did gold restorations except in extreme situations where it was the only realistic material.  But I have seen too many gold crowns, gold onlays, gold inlays, and even gold bridges that are 30-, 40-, or even 50+ years old!  While very few dental materials have been in use longer than 30 years, of those, none have had the longevity of gold.  So what are the advantages of gold?

• It requires minimal drilling of a tooth to have sufficient thickness to be strong – only 0.5mm (trust me, that’s SMALL!)

• It has the ability to deform slightly over time to match changes in adjacent teeth

• It can be burnished, or “massaged” hard to the tooth edge to create an amazing seal against bacteria, sugar, acid, etc.  Only in the last few years have porcelains reached equivalent seals, and even then the porcelains require absolutely exquisite bonding technique or they’re doomed to early failure.

So here is today’s example of a tooth with a failing silver/amalgam filling (decay around the edges and deep cracks that could have led to the tooth breaking at an inconvenient time) replaced with a gold onlay:

Family dentist Dr. Charles Payet used a gold onlay to fix a cracked tooth that had an old silver filling.

The gentleman who chose this is around 40 years old, and with regular dental care and the same excellent home care he has, this tooth and gold onlay will probably last until he is no longer in need of teeth any longer.

Cosmetic Dentistry in Charlotte: Correcting a Gummy Smile with a “Gum Lift”

Smile Makeovers can take many shapes and forms, and it is so important IMO for a dentist to be fully informed and trained on DIAGNOSING all kinds of smile problems and knowing the APPROPRIATE recommendations to make, because if an improper diagnosis is made, then the wrong treatment can easily be chosen, which will only result in a less-than-satisfactory result and an unhappy patient.  Here’s a perfect example:

Mia first came to my office in March of 2007 to ask if Porcelain Veneers could give her the smile she’d always wanted.  Her complaint was that her teeth were too short and square, and she hoped that veneers could make them longer.  However, the problem was NOT that her teeth were too short; the problem was that she had too much gum COVERING her teeth, making them appear shorter than they really were.

Mia’s Smile Before

Smile Makeover to Correct a Gummy Smile - BEFORE picture

As it turns out, Mia also had old dental crowns and bridges that were in need of replacement.  Unfortunately, the dentist who had placed them 20 years ago did not recognize the excess gum problem (turns out there was also excess bone covering the teeth, but you probably don’t want to see the surgical photos, right? 😉  ), and so he placed the edges of the crowns and bridges too far under the gum, resulting in chronic gum irritation.  The human body simply does not like it if you put dental materials (gold, amalgam, porcelain, composite resin, doesn’t matter) too close to the bone and too far under the gum, so the gums get irritated and will always bleed when brushing and flossing, sometimes even just to the touch.  We’re replacing the existing dental work over time, but we were able to do the right side work at the same time as the “Cosmetic Gum Lift,” which really made a big improvement.  (When looking at the photos, it’s on the left side of the pictures.)

So after plenty of consultation, Mia decided to go with the corrective gum surgery.  The technical name for this is “Esthetic Crown Lengthening,” which simply means that we are making the teeth look prettier (esthetic) by making them look longer.  She told us beforehand that she felt very nervous, but afterwards said that it was much easier and  less uncomfortable than she’d expected, and her healing was much easier than she’d thought.  Usually the only discomfort is some gum soreness, really.

Mia’s Smile After

Mia tells us she is simply THRILLED with her smile now, and it’s easy to see why!

Smile Makeover to Correct a Gummy Smile - AFTER picture

And for Mia, one of the best parts of the whole treatment was that we were able to do everything right here at Smiles by Payet Dentistry, with no need to refer her to a specialist.  I really loved giving Mia the smile that she’d always wanted, with no unnecessary drilling for porcelain veneers that would not have solved her problem in the first place.  We did also replace her old crowns and bridge on the upper right, and with the excess gum tissue removed there, too, now she has no problems keeping the area clean, and her gums don’t bleed when she brushes or flossing.  Next will be the upper left side.

Does dentistry last forever?

This is a question I’m frequently asked, especially when a patient is considering a significant investment of time and money into some form of cosmetic dentistry, such as:

• Porcelain veneers
• Bonding (tooth-colored fillings)
• Porcelain crowns and bridges
• Teeth whitening
• Even Six-Month Braces

It’s a very understandable question, and the simple answer to the question, “How long will my dental work last, Dr. Payet?” is “It depends.”

Just like a car, your teeth and gums require regular care to ensure that they are working properly.  Sure, you can go 10-20,000 miles between oil changes given how improved cars are nowadays, but do you really want to take the risk?  Same thing with teeth……….some people go for 5-10 years with no dental check-ups and are fortunate when they come in to find no problems, such as cavities or gum disease. But it’s not many people that are so lucky!

I always remember a quote from some lecturer at a dental conference years ago telling us his response whenever a patient asks the question, and it’s really the most honest, best answer that can be given, “Clearly the teeth that God gave you haven’t lasted your entire life, and since I can assure you that my work is not nearly as good as God’s, unless you die first, the work I do (no matter how excellent) will not last forever either.”

So what can cause your dental work to fail?

• Grinding your teeth — when the human jaw clenches, it can create an amazing amount of force, and over time, enough clenching will cause teeth to crack and break.
• Acidity — anything that increases the acidity in your mouth is good for the bacteria that cause cavities in particular, including Acid Reflux, Sodas, Power drinks (Monster, Red Bull, etc), Sports drinks (Gatorade, Powerade, etc).
• A very sugary diet — the bacteria that cause cavities love sugar.  High sugar content means the bacteria feed like crazy, produce acid, and the acid is what eats away the teeth to cause cavities.
• A compromised immune system — your saliva contains important antibodies that help keep the cavity-causing bacteria under control.  If your immune system is knocked back due to a disease or some medication, those antibodies will be decreased, allowing the bacteria to grow uncontrolled.
• Decreased saliva (dry-mouth syndrome) — again, due to medications or illness, the amount of saliva may be decreased.  With less saliva, there is less “washing” action of the teeth.
• Trauma — obviously.  LOL  One of my patients a few years ago fainted and fell face-first into a brick wall, shattering a front tooth.  Another ran into a pole, shattering another front tooth.  Clearly, if you are injured in such a way that your natural teeth would break, any dental work will break, too.
• Bad habits like chewing hard candy or ice regularly — hard candy and ice are just that — HARD!  Ice, in particular, is easily as hard as your enamel and as porcelain or bonding.  So if you bite down on ice frequently enough and/or hard enough, you can break your teeth and dental work.

That covers most of the major causes of dental work failing.  With regular care, use of appropriate mouthrinses and toothpastes, proper brushing and flossing, regularly scheduled check-ups and dental x-rays, using a nightguard, and being aware of diet, etc, your dental work can and should last a very long time.

But always remember — my dental work isn’t as good as the natural teeth God gave you, so my work probably won’t last forever either.  😉