Cosmetic Dentistry

How do I choose the right dentist for me?
Valid accreditation in cosmetic dentistry is very important since almost all dentists can claim varying degrees of experience in “cosmetic” dentistry. An advanced level of skill is important for delivering excellent results. Dr. Gershkowitz is happy to provide you with documentation of her work on patients with similar issues, and will discuss her advanced training and continuing education pursuits. Exceptional cosmetic dentistry is not an accident. Be sure you feel comfortable with your dentist and are given the opportunity to ask lots of questions and approve a plan together.
What general dentistry must be satisfied before considering aesthetic procedures?
At Sola Dental Spa we focus on both general and cosmetic dentistry because we feel strongly that nothing is more beautiful than a healthy smile. Dr. Gershkowitz will first examine the “foundation” of your smile prior to improving it aesthetically because it is the only way to assure lasting cosmetic results. Your teeth will be cleaned and x-rays will be taken. Your gum condition will be assessed. Once any clinical issues are satisfied, it will be time to discuss your aesthetic goals—starting with a “clean slate.”
Is cosmetic dentistry expensive?
Cosmetic dentistry is elective. Investing in your smile is a very personal decision. The two questions you should ask yourself are, “How do I choose the right cosmetic dentist?” and “What am I getting for my money?” It is a good idea to visit several dentists to see where you feel most comfortable. At Sola Dental Spa we are confident are fees are comparable to other dentists of our caliber, however our value is in our expertise, knowledge, technology and the one-of-a-kind atmosphere we have created.
I have bunched up, crowded teeth. What procedures might you suggest?
With any cosmetic treatment, one of the goals is symmetry. The first line of treatment may be orthodontics to reposition the teeth. New and improved “braces” called Invisalign can be used to discreetly improve your smile. Uneven teeth can be reshaped and laminated with veneers instead of braces for “instant orthodontics.” This method can close large gaps and correct overcrowding. The extent to which this approach can be successfully used depends upon how crowded and crooked your teeth have become. Often a combination of limited traditional orthodontics and cosmetic enhancement may be the best choice.
My cavities are all filled with silver and gold. What do you recommend so they are less noticeable?
Today, tooth colored fillings are considered commonplace. Silver fillings left in the mouth too long can hurt you in two ways. First, if the margin is not fitting perfectly, bacteria can get in between the enamel and your filling and eventually decay your existing tooth. Second, if you have micro cracks in that tooth, the filling no longer gives you the protection that an intact tooth would, making the tooth more susceptible to fracture especially if the metal has expanded or corroded over time. A small percentage of the population has mercury sensitivity and should replace all their silver fillings as a precaution.
I have a gap between my front teeth. Two of my lower teeth are cracked. Can you help me?
Bonding can close those gaps in front of your teeth and fix cracks. Tooth colored plastic material is placed between or on the teeth. The advantage of bonding is that it can be done in one appointment and does not cost as much as veneers. One of the problems with bonding is that over time the color can change and replacement is usually necessary in 3 to 7 years. If your budget allows you should consider veneers. They are stronger, more durable and become seamlessly integrated with the original tooth.
What are the pros and cons of various tooth whitening procedures? How is OTC different from what a dentist can do?
Dr. Gershkowitz recommends a combination of laser bleaching followed up with take home bleaching trays for the best results. Patients should avoid over the counter alternatives since they use trays and strips that are not individually fitted and will not give you consistent, long lasting results. They also increase the risk of burning gum tissue and causing bite problems. Severely discolored teeth, as in the case of tetracycline exposure, will not respond to whitening procedures. Porcelain veneers are a great solution to this condition.
Can you fix a gummy smile?
If your lip comes up too much when you smile, or your teeth appear short, you may have what some people call a “gummy smile.” Dr. Gershkowitz can trim excess or uneven gum tissue to make teeth look more proportioned using laser or traditional surgery. However, the technique chosen is very dependent upon your particular situation. After a gum lift, more of the tooth’s surface may be exposed, and veneers applied for a brilliant smile. The healing time is very short and predictable and results are dramatic.
If I have missing teeth, do I need false teeth? What are my options?
There is no reason to suffer with missing teeth. Not having a full set of teeth can effect your speech, digestion, and sense of taste, not to mention self esteem. All your other teeth will last longer when you balance the stress by filling in missing teeth. Today, false teeth are discouraged. They are inconvenient and ill fitting. Implants are artificial roots grafted to the jaw bone and fitted with a crown. They become part of your anatomy and last a lifetime.
When would you suggest bonding vs. veneers?
Porcelain veneers or Lumineers are thin shells of porcelain bonded over the front surface of the tooth. They are long lasting, stain-resistant and very natural looking because they can be shaped, lengthened, widened and whitened. Dr. Gershkowitz has a reputation for closely matching the personality of her patients with their veneers. Aside from cosmetically improving existing teeth they can also be used to correct misaligned teeth, crooked teeth or worn and chipped teeth. Bonding is often used to fix chips, gaps and other imperfections. It usually takes just one appointment and involves roughening the tooth’s surface and applying an enamel like tooth colored material to the area before it is hardened with a special light and polished. Bonding can be used to add length to the teeth or to restore and protect areas of decay. Lasting 3 to 7 years, bonding is less expensive than veneers, but does not give near their duration.
How exactly are Veneers applied?
The tooth is reshaped initially to allow for the added thickness of the veneer. A molded image is taken of the reshaped tooth and sent to a dental laboratory where the veneer is custom-made to fit your mouth. The veneer is applied with adhesive material which bonds it to the original tooth structure.The tooth is reshaped initially to allow for the added thickness of the veneer. A molded image is taken of the reshaped tooth and sent to a dental laboratory where the veneer is custom-made to fit your mouth. The veneer is applied with adhesive material which bonds it to the original tooth structure.
How many office visits will it take to fix my teeth and improve my smile?
That will vary for each person, depending on his or her needs. Sometimes, you can dramatically improve your oral health and appearance in just a couple of visits. Dr. Gershkowitz will work to make your treatment as convenient as possible, perhaps choosing slightly longer visits instead of more trips to the office. Talk to her about your goals and concerns so the best plan can be developed for your individual situation. If you start today, a new smile can be yours sooner than you think.
What does full mouth reconstruction mean?
Full mouth rehabilitation dentistry seeks to correct imperfections and enhance the appearance of the smile by combining the science of neuromuscular dentistry with the artistry of cosmetic dentistry. Anyone with worn, chipped, or broken teeth is a good candidate for full mouth rehabilitation dentistry. The procedure seeks to rebuild every tooth in the mouth and requires a truly qualified dentist to complete the treatment. Full mouth rehabilitation requires an advanced treatment procedure that uses state-of-the-art technology. A significant portion of the procedure involves the dentist deciding an appropriate course of action individualized for the patient’s particular needs. During this phase sophisticated tools are used to measure mouth formation. The goal of treatment is to properly align the jaw and rebuild damaged teeth. Jaw position is typically corrected using a plastic orthotic that fits over the top of the teeth. Teeth are restored with veneers, crowns, or onlays. Depending on the patient, prosthesis may be used. The result is an attractively enhanced smile using durable materials that will stand the test of time. Your results depend upon an appropriate treatment plan designed by a full mouth rehabilitation specialist. Specific techniques may vary depending on your needs. Although the process can be extensive, the results are amazing.
Is there a way to “try” before I “buy”—test drive my smile?
Yes. Visualizing your result is half the fun. After we get a good idea about your expectations we will determine what smile elements will best meet your desires. We use digital imaging where you can compare different options. Impressions are taken of your mouth to create the ultimate blueprint. Once your impressions are delivered back from our lab, we put them on your teeth as a temporary acrylic model for a 3 dimensional trial. You can wear these temporaries for several days and determine what adjustments you would like to make. The design and “test drive” phase are very important because most procedures are irreversible.
What if I have stained or chipped teeth?
Stained or chipped teeth can be corrected in one of three ways, or a combination of any three. Bonding involves application of tooth colored materials to the surface of the tooth and can repair discoloration, chips and gaps. Bleaching alone can lighten teeth that are colored or stained. This can be done at home with custom fitted trays, or in the office with Zoom Whitening in an hour. Veneers can cover teeth than are stained and correct chipped teeth on a more permanent basis.

General Dentistry

How often should I be seeing a dentist if nothing hurts?
It is important to maintain your oral health by visiting the dentist twice a year for cleaning and x-rays. Prevention is 90% of the cure. Gum disease and decay take place incrementally and may not have many symptoms. Addressing dental health early minimizes the treatment required for a healthy smile.
Why is flossing such a big deal?
Simply put, flossing is your first defense against gum disease. Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. The word periodontal literally means “around the tooth.” By flossing around the teeth you are taking the first step toward discouraging serious infections that left untreated can lead to tooth loss. Brushing alone is not enough because it cannot remove bacteria and food particles from between the teeth.
My gums bleed sometimes. Is that bad?
Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good at home oral care.
When do you recommend an onlay vs. a crown?
A crown refers to a cap that completely covers the tooth. This is generally necessary when teeth have gotten weak from previous large fillings to protect them from fracturing, or for teeth that have fractured and need additional support. Crowns are also used on top of implants or on teeth that have had root canal treatment. Inlays and onlays are custom fabricated restorations that are placed in teeth that are too broken down for a filling to be placed. They are aesthetically pleasing and natural and can actually strengthen a badly broken tooth. It is a more conservative method of protection than a crown.
My teeth seem sensitive lately when I drink hot or cold. What is causing that?
Depending on the severity of the sensitivity, it is best to have a dentist diagnose the cause of your discomfort. Over time, gums may recede causing areas of the tooth to become exposed and sensitive. There may be a gap between one of your fillings and the tooth where decay has set it. Some patients experience mild sensitivity following whitening procedures. In any case, provided that there is no clinical cause for the pain, there are in-office treatments that Dr. Gershkowitz can perform that will block tooth pain. In mild cases, she may recommend specialized toothpaste.
I grind my teeth and my jaw is starting to hurt. Can you help me?
Teeth grinding is more common than you may think and can become debilitating if left untreated. It can also severely compromise your teeth. Since most grinding takes place at night, Dr. Gershkowitz can design an appliance you can wear while you sleep to minimize the effects of grinding. Most patients see a marked improvement in the number of headaches, neck aches and jaw pain as a result.
Can my teeth be causing bad breath?
Bad breath has many causes. It could be caused by bacteria, smoking, spicy foods, medication or dry mouth. Chronic bad breath is often associated with gum disease or restorations that have aged and become faulty. Dr. Gershkowitz can determine the cause and recommend a solution to give you back your confidence.
I have not had my teeth cleaned for 4 years. What can I expect at my appointment?
Depending upon the condition of your gums and teeth, the cleaning may be staged over two or three visits for your comfort and convenience.
Dentists have always scared me. What can you do to make me comfortable?
Part of the philosophy behind Sola Dental Spa is to change your mind about the way dentistry is practiced. Our office has been designed to anticipate and eliminate any fear you may have through massage, aromatherapy, entertainment, and Dr. Gershkowitz’ gentle approach to all your dental needs. We will work with you to determine exactly how you define comfort and go “beyond” your expectations to assure a pleasant experience.
Does smoking affect a person’s teeth?
Cigarette smoking has long been known to be associated with a variety of oral conditions including periodontal disease, bone loss, tissue loss, tooth loss, edentulism, peri-implantitis and dental implant failure. Nicotine in tobacco has been shown to reduce the blood flow in the mouth. Pipe smoking can be worse than cigarettes due to the higher temperatures generated in the upper jaw. Not only is smoking detrimental to implants, it is also bad for conventional bridgework. In addition to increased prevalence, smokers also experience more severe periodontal disease.
I have heard some people need premedication prior to dental work. Can you explain this?
Premedication is required for some patients. Any time there is bleeding in the mouth, oral bacteria can enter the bloodstream and travel to the heart. This presents a risk for some patients who have an artificial heart valve, a history of infective endocarditis and certain specific, serious heart conditions. New guidelines state that antibiotic premedication is no longer indicated for dental patients with mitral valve prolapse; rheumatic heart disease; bicuspid valve disease; calcified aortic stenosis; or congenital heart conditions, such as ventricular septal defects, atrial septal defects, and hypertrophic cardiomyopathy.
Is there a health risk from daily low-level mercury exposure from dental fillings?
We do not know if the trace amounts of mercury that are released daily from dental fillings have an impact on a person’s health. The World Health Organization has looked at various levels of mercury exposure and determined the threshold for when mercury exposure becomes toxic. Based on those studies, it would take 265 to 312 amalgam fillings to reach toxic levels of mercury exposure, according to J. Rodway Mackert, dental professor and materials-science expert at the Medical College of Georgia in Augusta. Some consumers and advocacy groups believe there is a link between mercury fillings and multiple sclerosis, Alzheimer’s disease and chronic-fatigue problems. There is no scientifically credible evidence supporting any link. But since the health impact is not fully understood, several European countries have restricted the use of dental amalgam and ruled that it should not be used in pregnant women.