DENTAL CARE SERVICES

 
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FASTBRACES

Straightening your teeth with the new fast technology FASTBRACES, in 3 to 12 months.

 
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ROOT CANAL

Restore your tooth to a comfortable state by removing damaged tissue and replacing it with substance to help preserve tooth functionality.

 
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Teeth Whitening

Get whiter teeth with our whitening treatment for a better smile and a bright life.

 
 
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Wisdom Teeth Removal

Removing teeth that develop in many different directions to prevent potential problems.

 
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DENTAL IMPLANTS

 
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Crowns & BRIDGES

At Dutton Dentistry we offer same-day crowns! This procedure consists of placing an artificial cover on an individual tooth to restore the decayed or damaged tooth to its normal shape and size. 

 
 
 
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TONGUE & LIP TIES

 
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LASER THERAPY

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INVISALIGN

 
 
 
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EXPANDER THERAPY

The doctor can widen the patient's smile using expander therapy before braces are applied. Due to the nature of the treatment, expander therapy is usually reserved for children (usually when they still have baby teeth present) and for teens or young adults in cases of very crowded teeth or crossbites.

Expander therapy uses expansion orthodontic appliances to widen the dental arch through sutural expansion of the upper jaw and by tipping the teeth of the lower jaw. This results in a broad, dynamic smile. It usually lasts 4 to 6 months per arch. The braces follow for additional fees, when all of the permanent teeth have erupted.

The process uses two kinds of expanders, the Upper Expander for upper teeth, and the Lower Expander for lower teeth. The results are obvious!

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LAUGHING GAS (Nitrous)

Nitrous Oxide (laughing gas) is an anaesthetic administered as the gas you breathe through your nose. Nitrous oxide makes you feel more relaxed and less anxious throughout the dental procedure. It is also very effective in reducing a hyperactive gag reflex and strain on TMJ. 

Laughing gas is very well tolerated by most patients and has a very high satisfaction and success rate. It is also very effective to use on patients who cannot tolerate long sitting such as kids.

GUM DISEASE THERAPY

Periodontal (gum) disease is an infection caused by plaque. Plaque is the sticky film composed mostly of bacteria that forms continuously on the teeth and must be removed as plaque bacteria produce toxins that irritate gum tissues causing them to swell. Gradually plaque hardens into calculus (tartar) that forms a rough surface on which more plaque accumulates, causing increased irritation and swelling.

This inflammation damages the periodontal fibers that hold the gum tightly against the teeth, creating spaces known as periodontal pockets. These pockets create room for even more bacterial activity which creates deeper pockets until eventually the bone supporting the tooth is destroyed, resulting in tooth loss. 

 

MEET THE TEAM

 
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DR. NEHAL AL TARHUNI, DDS

 
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DR. HEBA AL TARHUNI, DDS

 
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CHERYL PERCIVAL, CDA I

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SHERRY SHERMAN, CDR

KATE PATTERSON, RDH

 
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MARY ELLEN TONER, RDH

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SARAH SIMPSON, CDA II

 
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JACQUELINE GOLEM, CDA II

 
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BECKY SIM, RRDH

 
 
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EMIRA DZINIC, CDA II

 
 
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APPOINTMENT Cancellation Policy

● Two full business days’ notice (48 hours) is required to change a scheduled appointment.
● It is the responsibility of the patient to remember their own appointment time, however our offices will continue to give courtesy reminders on average 1 week in advance as well as 1-3 days before scheduled appointment date.
● If text/email reminders are the preferred contact method, please inform us by filling out the last portion of this letter.
● Patients are highly encouraged to arrive 5-10 mins prior to their procedure start time as often there are forms that need to be updated such as medical history and or procedures that preparatory in nature that needs to be done prior to initiating treatment. Arriving late may result in having your procedure cancelled or altered due to lack of time in the schedule.


Private Dental Insurance Policy
We currently are an “assignment” office, meaning that, for the convenience of our patients, we are willing to have the insurance assigned directly to our office allowing the patient to pay any
remaining balance. However, Since insurance policies are agreements made between the patients themselves and the insurance provider, it is solely the patient's responsibility to maintain and review the coverage level and details. Our offices will happily provide the patient with any assistance required to understand their coverage. Our offices will also submit pre-determinations for any treatment plans upon request.


To enable assignment of benefits PATIENT MUST :
● Present a current insurance card at each appointment
● Determine the maximum $’s the plan covers per year **
● Determine the frequency for coverage of recall exam/polish/fluoride **
● Determine the number of units of scaling allowed per year **
● Determine whether the benefit year is a calendar year OR rolling months **


**These insurance details can only be accessed by calling insurance provider, online through the insurance company or by contacting the HR office of the employer. Please note that the insurance company may not give our office this information due to privacy laws.**


PLEASE NOTE: Our office accepts assignment of benefits from most insurance companies. Some insurance companies do NOT allow assignment of benefits and pay directly to the patient. In such cases, the patient would be required to pay the balance owing on the date of each appointment and we will submit the dental claim on their behalf.


Government issued insurance policy
Our offices are pleased to provide non-discriminatory quality oral care to our community members. We, therefore, accept both private and government funded dental insurance programs.
1) Patient must check their own eligibility for coverage, coverage cards come with an expiry date.
2) Patient must present their card at each appointment or risk that treatment may not take place that day until a proof of coverage is produced
3) If the patient consents to accepting a treatment modality or purchasing a product that is otherwise not covered by their plan, they will be fully responsible for the payment of such services when rendered.


90 Day Policy for Secondary Insurance
As stated above, our office accepts assignment of benefits. Unfortunately we do not have the ability to send secondary insurance claims electronically. In cases where a patient has secondary/dual insurance, we will require the policy holder’s original signature on the claim form in order to be paid from the second company. This also applies to primary insurance for some patients (ie: Global Benefits) as they do not have the capability for the office to submit electronically and therefore are sent by paper claim. We will gladly give the patient the secondary insurance forms before leaving the office for the policyholder to sign, and give the instructions whether to bring it back to the office or send it directly to the insurance company as this will differ depending on the situation. If we do not receive payment from either insurance company after 90 days then the patient will be responsible for the outstanding balance and will need to consult with the insurance company privately. We will gladly provide any paperwork necessary for you to receive payment.



FASTBRACES

What Makes Fastbraces So Fast?

There are no miracle shortcuts in orthodontic treatment, but Fastbraces new technology is different, allowing treatment that lasts months, not years. Traditional braces treatment works by moving the tooth crown (the part that you see, outside your gums) in the first year, then moving the tooth roots (the part anchored in your gum and jawbone) in the second year. Fastbraces moves both the entire tooth, both the crown and the root, toward its final position at the same time, from the onset of treatment. This cuts the treatment down to about three to 12 months.

New Innovative Design

At a glance, Fastbraces may not appear very different from traditional braces. Take a close look and you’ll notice a fundamental difference. While traditional braces have square brackets, Fastbraces have rectangular brackets. This innovative change in design actually changes the angle of the forces that act on your teeth during the treatment process, speeding up the movement of teeth while keeping the process gentle.

No Tightening Needed

Another key to the quicker and gentler treatment is the use of a single wire. Traditional braces usually use a series of wires over the course of several months, switching them in and out. Fastbraces uses a single square super-elastic nickel-titanium wire which is activated by the special design of the brackets and the natural heat of your mouth. No need to have your braces “tightened”.

Minimal Time Wearing a Retainer

Unlike traditional orthodontic treatment in which the patient sometimes has to wear their retainer all the time, Fastbraces requires less retainer wear. After Fastbraces treatment, the patient will wear a retainer at night while they sleep (typically about 8 hours). We like to call this “teeth pajamas”. Or the patient may only need to wear the retainer for 15-20 minutes each day (for example, while showering and getting dressed). We call this “teeth shampoo”. The dentist will give you specific instructions for your post-Fastbraces retainer routine. After about a year, some patients only have to wear their retainer for a few minutes!


TRADITIONAL BRACES VS. FASTBRACES

            Old Style Traditional Braces                                              New Technology Fastbraces

                      University Tested                                                               University Tested

                  Used for Decades                                                          Used for Over 20 Years

                    Square Brackets                                                             Triangular Brackets

                  Complex Treatment                                                               Simple Treatment

          Often Changes to Natural Bite                                                Natural Bite Preserved

             Extractions Needed Often                                                Almost Always Non-extraction

                 Multiple Wires Used                                                                  Just One-Wire

           Multiple Radiographs Needed                                One Radiograph of All Roots Needed

           Often Treatment by Specialist                                              Treatment by General Dentist

                Typically 1.5-3 Years                                                         3 Months to About a Year

                  Typically High Cost                                                                 Typically Low Cost

              Delayed Root Movement                                                    Immediate Root Movement

                    Root Resorption                                                              Less Resorption Statistically

               Pain Issues Reported                                                        Pain Reduction Statistically

             TMJ Joint Issues Reported                                                   No TMJ Issues Known

              Typically 24/7 Retainers                                              Typically 15-20 Min./Day Retainers

     Short-term Ortho Necessary for Cosmetics                                  Short-term Ortho Redundant

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APPOINTMENT BREAKDOWN

First and Second visit:

If the patient has a deep bite (overbite) tendency, they will receive the upper braces during this visit in order to reduce the overbite, and receive the lower braces on their second visit. If the teeth don’t overlap enough, the patient will typically get the upper and lower front braces during the first visit, and the upper and lower back braces on the second visit or a combination of the above as per the doctor’s recommendation for each individual case. 

The braces will be placed close to the gums if one has an open bite tendency, or close to the edge of the teeth if one has a deep bite (overbite) tendency.

Third and remaining visits:

Adjustment of the braces is done by changing the elastic ties around the braces or by re-positioning, adding or removing one or more of the braces. 

    Aligners Necessary Alternative                                             Aligners Rarely Needed

          Typically No Guarantee                               Lifetime Commitment by Participating Providers

            No Referral Network                                                    Worldwide Referral Network

 

 

ROOT CANAL

Root canal therapy fits under the special dentistry area known as endodontics. Endodontics literally means dentistry within the tooth itself. The procedure treats disorders of the pulp. 

Endodontic treatment restores your tooth to a comfortable state by removing the damaged tissue and replacing it with substance that will help preserve the function of the tooth.

There are many reasons that a root canal maybe needed by the most common cause is the caries process (uncontrolled process of tooth decay). When tooth decay begins, it penetrates the outer layer of enamel and creates a cavity. If that process is not stopped, the decay will continue toward the nerve of the tooth.

Other causes include a fracture to a tooth, a cracked or loose filling or repeated fillings in a tooth and occasionally from periodontal disease. Regardless of the initial cause, the tooth pulp becomes irritated and an abscess within the tooth pulp dies, causing the bone around the tooth to be destroyed.

 

 

 WISDOM TEETH

Wisdom teeth are the last teeth to come in and the ones least needed for good oral health.

The third molars, or wisdom teeth, are called such because they develop when most individuals become adults (near 17 years of age).

Because our jaws are smaller than our ancestors*, our wisdom teeth may not have enough room to fit in our mouths properly. Therefore, problems may result if these additional teeth attempt to emerge.

Most people have four wisdom teeth, one in each corner of the mouth, and often they are impacted (trapped in the jaw bone and gums). Cramped for room, these impacted teeth grow in many different directions and removal may be recommended by your dentist to prevent potential problems.

Whether wisdom teeth cause your mouth harm depends on several factors, including the size of your jaw and how your wisdom teeth grow in. You may have no symptoms at all, but other teeth in your mouth could be at risk of damage. Help make your treatment a success by understanding why your wisdom teeth may need to be removed, what the procedure involved and what you can do to promote a successful recovery.

*Our ancestors needed large jaws and more teeth for their tougher diet. Since our lifestyle has changed and we eat softer foods, we no longer require that extra chewing power.

If you learn the different ways wisdom teeth can develop and the problems that can arise, you’ll be better able to understand why you may need to have them removed.

It is best to have wisdom teeth removed around 17 years of age because that is when they usually develop. Removal will be easier as the bone may not be as dense as in an older person. Also, recovery will be faster since the roots usually have not yet fully developed.

 
 
 
 
 

Infection in the Gum: When a wisdom tooth partially breaks through the gum’s surface, bacteria can get under the flap, causing an infection in the gum.


Crowding Displaces Next Tooth: An impacted or erupting wisdom tooth can push on adjacent teeth, causing them to become crooked or even damaging structurally.

Decayed Wisdom Teeth: Decay forms in a wisdom tooth that is hard to clean due to its position or because it is partially covered by the gum tissue which may collect cavity causing bacteria. 

Poorly Positioned Wisdom Teeth: A wisdom tooth that grows toward the cheek can irritate nearby tissue. If an erupted tooth is crooked it may be hard to clean or make it hard to bite down.

Cyst Destroys Bone: If the sac that hold the crown remains in the bone, it can fill with fluids, forming a cyst that can destroy surrounding bone.

 

 EXPANDER THERAPY

The doctor can widen the patient's smile using expander therapy before braces are applied. Due to the nature of the treatment, expander therapy is usually reserved for children (usually when they still have baby teeth present) and for teens or young adults in cases of very crowded teeth or cross-bites.
Expander therapy uses expansion orthodontic appliances to widen the dental arch through sutural expansion of the upper jaw and by tipping the teeth of the lower jaw. This results in a broad, dynamic smile. It usually lasts 4 to 6 months per arch. The braces follow for additional fees, when all of the permanent teeth have erupted.

The process uses two kinds of expanders, the Upper Expander for upper teeth, and the Lower Expander for lower teeth. The results are obvious!

STEPS & APPOINTMENT SEQUENCE

a. First Visit: The doctor will size the back teeth, and then take a mold of the teeth in order to custom-make the expander.

b. Second Visit: The patient comes back a few weeks later to get the Upper and/or Lower Expander. At this appointment, the doctor will try it in the mouth of the patient and make some minor adjustments before cementing it with a special adhesive. The doctor will also show the patient how to turn the expander and give instructions on how to keep it clean.

c. Third Visit: If enough expansion has been achieved, the expander may be removed at this appointment. If more expansion or stabilization is required, the expander will be left in place until the next appointment.

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UPPER EXPANDER  - AFTER -

UPPER EXPANDER

- AFTER -

LOWER EXPANDER  - BEFORE -

LOWER EXPANDER

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LOWER EXPANDER  - AFTER -

LOWER EXPANDER

- AFTER -


FAQ’S

HOW LONG WILL IT TAKE THE PATIENT TO ADJUST TO THE EXPANDER?

The first couple of days, the patient may feel like food is stuck between the teeth, and the tongue may get sore from touching the expander while talking. The patient needs to keep it clean with a toothbrush and mouth rinses. During these first few days, the patient will experience discomfort because the teeth are moving for the first time. This will subside significantly as the treatment progresses. The patient may take ibuprofen (Advil) to relive the discomfort or Acetaminophen (Tylenol).

WHY DOESN’T IT WORK AS WELL FOR ADULTS?

The expander works by widening the midpalatal suture of the upper arch. This suture is in the roof of the mouth and it turns into bone after puberty. Once the bone is set, expansion may be painful and not stable. In the lower arch the teeth mostly tip once the permanent canines have erupted fully.

HOW LONG DO THE RESULTS LAST?

In children and adolescents the results are permanent. Retainers, of course, will have to be worn after the braces. In adults, the results are pretty stable as long as the expansion in minimal.

WHAT HAPPENS IF THE EXPANDER CANNOT BE TURNED ANYMORE?

When the patient has reached the end, the expansion screw will not turn any more. The patient should leave it alone until the next appointment.

WHAT IF THE EXPANDER COMES LOOSE AND ONLY ONE SIDE COMES OFF?

The patient should wiggle the other side out. If it does not come out, the patient should call the office to schedule an appointment to re-cement it. The patient should be careful chewing in the meantime.

WHAT IF THE EXPANDER COMES OFF?

The patient should remove it, and NOT throw it away. The patient should call the office to schedule an appointment to re-cement.


 TEETH WHITENING


 DENTAL IMPLANTS


 CROWNS

A crown (often called a cap) is an artificial cover that is placed on an individual tooth (somewhat like a
thimble over your finger) to restore a decayed or damaged tooth to its normal shape and size. 


This procedure is often necessary when there is no longer sufficient tooth structure left to place a filling. It is also
useful for protecting teeth that are cracked or broken. A crown can also be used to change the shape of a tooth, to
correct a bite or cosmetic problem, or to replace existing broken or poor-fitting crowns. A crown may be made of gold,
other metals, or porcelain which makes them durable and strong, so replacements are needed less often.

 
 

BRIDGES

Fixed bridges, quite simply, replace missing teeth to make chewing easier, improve appearance, and keep your teeth, gum, and jaws healthy.

Bridges consist of one or more replacement teeth attached to the natural teeth next to them. They are made of various metals, porcelain, or a combination of the two.

Each upper tooth contacts the corresponding lower tooth, allowing for a well-balanced chewing function. Losing a tooth quickly destroys this balance. Just one missing tooth can cause the position of other teeth to change- some teeth may tilt forward, or opposing teeth may move down.

A missing tooth can also create spaces between your teeth, changing your bite and smile. These shifting, drifting, and titling teeth can cause a variety of problems such as difficult or painful chewing (due to changes in your muscles, bones, and joints), or abnormal decay areas (due to teeth that are hard to reach to keep clean) which accelerate periodontal (gum)disease.

Generally, if the missing tooth is not replaced, more teeth may eventually be lost due to the improper forces exerted during chewing.

  • It will take two or more dental visits to prepare and fit our bridge. First your dentist reshapes the support teeth that will hold the crowns of your fixed bridge.

  • Then an intra oral scan of the prepared tooth, and of the surrounding and opposing teeth, is taken. If appearance counts, your dentist selects a shade from a guide to make sure the replacement teeth match the shade of your natural teeth.

  • To protect your prepared teeth while the fixed bridge is being made, your dentist may fit a temporary bridge that is held in place by temporary cement.

  • With our in-house milling system, we are able to fabricate your crowns and bridges right on site and can be delivered that same day a couple hours later.

  • Be careful when cleaning your teeth or eating, because your temporary bridge can loosen.

  • Let your dentist know immediately if the temporary bridge comes off or does loosen.


 
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 LAUGHING GAS

Nitrous Oxide (laughing gas) is an anaesthetic administered as the gas you breathe through your nose. Nitrous oxide makes you feel more relaxed and less anxious throughout the dental procedure. It is also very effective in reducing a hyperactive gag reflex and strain on TMJ. 

  • Laughing gas is very well tolerated by most patients and has a very high satisfaction and success rate. It is also very effective to use on patients who cannot tolerate long sitting such as kids.

  • Nitrous is administered in gas form, therefore if you have difficulty breathing, sinus infections, or upper respiratory tract infections you might not be able to have nitrous. However, once the condition is resolved you should be able to take advantage of this treatment.

  • Nitrous is not advised during pregnancy. It has been reported that nitrous can increase the risk of pregnancy complications.

  • Children who are too young to comprehend surroundings may feel uncomfortable and respond unfavourably.

INSTRUCTIONS

1- Do not eat or drink for at least two hours prior to your appointment, this will help you not feel sick.

2- Arrive 15 min early to allow time for medical assessment of your vitals by our staff.

3- You will be able to drive after your appointment, therefore you do not need to bring a driver with you. 

Advise us of any medical changes in your health such as sleeping or sedative medications.


 GUM DISEASE

Periodontal (gum) disease is an infection caused by plaque. Plaque is the sticky film composed mostly of bacteria that forms continuously on the teeth and must be removed as plaque bacteria produce toxins that irritate gum tissues causing them to swell. Gradually plaque hardens into calculus (tartar) that forms a rough surface on which more plaque accumulates, causing increased irritation and swelling.

This inflammation damages the periodontal fibers that hold the gum tightly against the teeth, creating spaces known as periodontal pockets. These pockets create room for even more bacterial activity which creates deeper pockets until eventually the bone supporting the tooth is destroyed, resulting in tooth loss. 


Other factors can also cause periodontal disease. These include local irritants such as smoking, chewing tobacco, or habitually clenching the teeth. Nutrition, certain medications, and high levels of stress can also be contributing factors.

In many cases periodontal disease begins at an early age and in its first stages is called gingivitis (gum inflammation); with the more advanced stage known as periodontitis or pyorrhea. Because the disease can be virtually painless, it is important to maintain regular check-ups so that your dentist can detect the presence of periodontist (a specialist in diagnosing, treating and preventing gum disease). Your periodontist does a more in-depth examination to determine the actual extent of your periodontal disease.

**Periodontal (gum) disease affect 3 out of 4 people over the age of 35 and is the most common cause of tooth loss**