Minimally invasive dentistry with a dental microscope

I sure wish I had the HD video hookup for my dental microscope already, but since I don’t yet, I’ll keep showing you stuff with my Canon cameras.  🙂

One of the most incredible benefits of the microscope is the ability to work on levels of detail that aren’t even imaginable without one.  And that means that I can do VERY VERY VERY VERY SMALL, CONSERVATIVE fillings.  I use teensy little burs to remove the absolute minimum amount of tooth structure, not really big ones that dig out way more than necessary.  I just wanted to show you an example of how this looks using a patient from this morning; the benefits of this are pretty obvious:

Teeth with small cavities that only need small fillings

Teeth after small cavities were cleaned out with very small preps, possible because of the dental microscope.

Teeth after very small tooth-colored fillings were done, possible because of the dental microscope.

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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

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.  😉

Updates on Invisalign

ALIGN Technology, the company that makes Invisalign orthodontic aligners, has not yet made any indication that they will be reversing their decision on June 1st to require dentists and orthodontists to do a minimum of 10 cases each year and complete 10 hours of their Continuing Education courses each year.  The backlash among dentists and orthodontists, however, continues to get stronger, as this is a fairly blatant move by a for-profit corporation to intrude on a doctor’s autonomy and decision-making rights as to which cases are appropriate for Invisalign and which are not.  Several professional organizations, including the Academy of General Dentistry and the New York State Dental Association, are already responding with letters to ALIGN Technology’s Board of Directors and President, stating that there is simply no evidence that the so-called “proficiency requirements” have any basis in science, and unless they can come up with something to substantiate the claims the company is making, they should immediately withdraw the requirements.  If ALIGN Technology continues on this course, patients should fully expect to see an enormous drop in the availability of Invisalign as more and more dentists and orthodontists simply drop their service.

The good news is that there are alternatives to Invisalign, and they work as well or better, AND they’re even less expensive!  For some info and examples, check out our Six-Month Smiles in Charlotte!  Then you can Request a Complimentary Consultation to see how fast you can feel good about your smile again with straight, white teeth!  And if you’re concerned about cost, if you sign up for our Dental Discount Plan or choose Interest-Free Payment Plans with Care Credit, you can save some real money, too.

A Complete Smile Makeover with Porcelain Crowns for Teeth Damaged by Bulimia

There are many reasons patients come to see me for cosmetic dentistry.  One of the most common reasons is because their teeth are badly worn down from grinding, often in combination with acid erosion that has eaten away at the enamel.  Treating these cases can be complex, because if we don’t properly diagnose and solve the problem that caused the worn, eroded teeth in the first place, then any cosmetic dentistry is sure to fail very fast.

When Jenni (not her real name, as she prefers to stay anonymous) first came to see me through a referral back in 2005 for a Smile Makeover consultation, she admitted that she had suffered from bulimia as a teen, about 20 years prior.  She had recovered from this debilitating disease and had been leading a healthy, normal life for many years, but her teeth had been so eroded that she was extremely self-conscious and embarrassed by her smile.

Since Jenni’s original issue had been addressed medically, we were safe moving forward with a greatly decreased risk of acid erosion causing problems again, although bulimics are at a much higher risk of GERD/acid reflux, so she is monitored regularly by her physician, and she uses a prescription strength fluoride rinse daily to help protect the teeth under the porcelain.

Due to complicating factors, Jenni’s case was just completed this year; however, I think you’ll see why Jenni is now happy with her smile again, although she doesn’t want everyone to know what she had done,  so she has asked me to not use her portrait.

Cosmetic dentist Dr. Charles Payet, of Charlotte NC, performed a Smile Makeover with Porcelain Crowns to Restore these Teeth Damaged by Acid Erosion/Bulimia

Baby Boomers – get your teeth fixed before you retire when you still have dental insurance and flex plans to help pay

With more and more Baby Boomers approaching or entering retirement, an issue often not considered is their dental health.  I think it is actually an important topic to discuss, even more so in today’s economy.

Many Baby Boomers – my parents included – have put retirement on hold, but it’s still not all that far away, and with retirement usually comes the loss of dental insurance and the loss of medical/dental Flex plans that can help a lot with covering the cost of dental care.  After that, it’s all out-of-pocket.  Ouch!  So we always recommend a thorough re-evaluation of existing dental work for things that may be on the verge of going bad.  Such things could be:

• Old silver fillings with cavities and cracks that could turn into root canals and crowns or extractions

• The teeth around the old silver fillings may have cracks that could lead to broken teeth

• Gum (periodontal) disease

• Ugly old crowns that could be replaced for a nicer smile in the golden years

• Replacing missing teeth with dental bridges or implants so you can eat the foods you want

• Etc etc etc……

This gentleman hadn’t been to the dentist in a number of years but knew that he was approaching retirement, so he wanted to come in, get a cleaning, and find out if he needed to take care of anything while he still had dental insurance.  Turns out that many of his 30+ year old silver fillings were in really bad condition, with pieces chipping off, cavities forming around the edges, teeth cracking, and gum disease to boot.

While the total treatment that he needed involved some gum surgery (not needed for everyone, obviously), the primary issue that we addressed was to clean out the old fillings and cavities, then rebuild the teeth with all-porcelain crowns on several teeth, 1 tooth got a tooth-colored filling, and 1 tooth got a gold 3/4 crown (most of the tooth, but not the whole tooth is covered by the crown).

He can now rest assured that all of the problems with these teeth are fixed, and it’s likely he will not need any of them ever worked on again as long as he takes good care of them.

Broken silver fillings with cavities, fixed with porcelain dental crowns, a gold dental crown

Dental payment plans, interest-free dental financing in Charlotte, NC

As I mentioned in my last post about patients without dental insurance, I would like to add that there is another great option that we offer at my dentist’s office in Charlotte, NC, and that is CareCredit.  A tremendous number of my patients have used the 3-, 6-, and 12-Month Interest-Free Dental Patient Financing to help them get their dental work done without putting them in a bind.

Check our website for the link to their Online Application, and you can have that ready when you come in, too.  The more you have done before you come in, the easier your appointment flow will be, and you can rest assured that you’re covered financially.

Interest-Free Dental Payment Plan offered by Dr. Charles Payet in Charlotte, NC

Smiles by Payet Dental Discount Plan

I thought I’d just mention this again, as we’ve had increasing interest in our Smiles by Payet Dentistry Dental Discount Plan; as far as I know, it’s the only Dental Discount Plan in Charlotte, NC that’s offered.  Patients are finding some real savings with it.  We are only offering this for patients with NO Dental Insurance; alternately, if you have an HMO or DMO plan and don’t want to see the dentist your network says you have to see, this option would work for you, too!

Discount Plan for Dental Patients in Charlotte NC offered by Dr. Charles Payet, Smiles by Payet Dentistry

Porcelain Veneers to Correct Crowded Teeth – 1 Option for a Beautiful Smile!

We’re often asked what is the “BEST” way to make a person’s smile the way they’ve always wished; should they do orthodontics (braces), should they have a “gum lift” (esthetic crown-lengthening), should they choose veneers?  Of course the answer is, “It depends.”   Each has advantages, each has disadvantages, so you must personally weigh each option very carefully to make the most informed decision for yourself.  The option that many choose for correcting crooked teeth, though, is that of Porcelain Veneers.

Veneers, also known as Laminate Veneers, are very thin porcelain shells, individually hand-crafted by a skilled laboratory technician, that are bonded onto the teeth.  There must be clear and excellent communication between the patient, the dentist, and the laboratory, for veneers can truly be customized to create the look that you want: Shape/Contour, Translucency, Color, Brightness…..

Veneers single biggest advantage over Braces is the speed with which a smile makeover can be completed.  Unless there are complicating factors (and there often are, so it’s wise to be prepared), a Smile Makeover can be completed with veneers in only 3-4 weeks.  Of course, the disadvantages are that some healthy tooth structure must be removed so the teeth don’t look like horses’ teeth, and the fee is usually significantly higher.

To demonstrate the remarkable difference that can be achieved with Porcelain Veneers to correct crowded teeth, here’s Linda:

Linda’s veneers (10 on the top, 10 on the lower teeth) were completed 6 years ago and are still providing Linda the smile she’d wanted since she was a child but never had.

Coming very soon: Short-Term Adult Orthodontics, or “Get your crowded front teeth straightened in just 6 months, not 2-3 years, with braces!”

Crowded teeth made straight in only 3 weeks with 16 Porcelain Veneers